To the Editor.
—I read the article by Tamboli et al1 with interest. I commend the authors for attempting to study the incidence of retinoblastoma in the United States, and although I think most of their conclusions are correct, they and the reader must be aware of significant problems with their approach. Their incidence figures, and those in an earlier report by Pendergrass and Davis,2 utilize the Surveillance, Epidemiology, and End Results (SEER) program for analysis. This is an appropriate way to study cancer in the United States in general but a poor way to study retinoblastoma in particular. They have studied a total of 220 cases from nine population areas in this country during an 11-year period. Because retinoblastoma treatment is concentrated in the hands of a relatively small number of groups in this country, they missed the data from New York, NY, and Philadelphia, Pa, which
Abramson DH. Retinoblastoma Incidence in the United States. Arch Ophthalmol. 1990;108(11):1514. doi:10.1001/archopht.1990.01070130016001
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