Screening and mortality from cervical cancer

BMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7210.642 (Published 04 September 1999) Cite this as: BMJ 1999;319:642

Does screening really reduce mortality?

  1. Jayant S Vaidya, honorary lecturer in surgery (j.vaidya@ucl.ac.uk),
  2. Michael Baum, professor of surgery
  1. Department of Surgery, Royal Free and University College Medical School, University College London, London W1P 7LD
  2. Office for National Statistics, London SW1V 2QQ
  3. Department of Community Medicine, University of Hong Kong, Patrick Manson Building South Wing, 7 Sassoon Road, Pokfulam, Hong Kong

    EDITOR—We were rather non-plussed to read that the conclusion of the paper by Quinn et al on screening for cervical cancer1 is not supported by their data, and we wonder whether so called political correctness had anything to do with it. The statement “800 deaths might have been prevented in 1997” is based on a projected mortality of a completely arbitrarily (alas, not randomly) selected part of a subset of graphs showing trends in mortality. The opposite conclusion may be reached using the same graphs. For example, in women aged 35-44 mortality fell from 10 per 100 000 to 5 per 100 000 in the period 1960 to 1975 and it should have approached zero by 1997 assuming that the trend had continued. Similarly, with the same age groups as in the original paper, in women aged 25-34 mortality fell from 2.5 per 100 000 to 1.1 per 100 000 in the period 1955 to 1965, so by 1997 it should have again approached zero. Since the only new intervention has been screening, and the mortality is …

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