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Bmj Usa


BMJ 2004; 328 doi: (Published 10 June 2004) Cite this as: BMJ 2004;328:E306
  1. Solveig Hofvind,
  2. Bj⊘rn M⊘ller, researcher,
  3. Harald Weedon-Fekjær
  1. Cancer Registry of Norway
  2. Department of Pathology Ullevâl University Hospital Oslo, Norway

    Following are edited excerpts from the Rapid Responses generated by this article, all of which can be read in their entirety at

    Unjustified conclusion on overdiagnosis

    Zahl et al have addressed the expected drop in incidence rate of breast cancer after women leave the screening program at the age of 69, and found no decline in incidence for the 70-74 age group. Since cancers detected by mammography were not compensated by a later drop in the rates, the authors concluded that the screening resulted in serious overdiagnosis.

    Unfortunately, they have made a crucial error in assuming that only women in the 50-69 age group were invited to screening in Sweden. According to Olsson et al,1 the Swedish screening recommendations from 1986 included women aged 40-74. Of 26 counties, 15 offered screening in the 70-74 age group from the start of their program, representing more than half of …

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