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PapersEffect of screening on incidence of and mortality from cancer of cervix in England: evaluation based on routinely collected statistics

BMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7188.904 (Published 03 April 1999) Cite this as: BMJ 1999;318:904

Rapid Response:

Does screening really reduce mortality?

Editor - We were rather non-plussed to read the conclusion about cervical cancer
screening by Dr. Quinn and colleagues (1) that is not supported by their
data and wonder whether “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 mortality trend graphs. Using the same
mortality trend graphs it is possible to reach an exactly opposite
conclusion. For example, in the age group 35-44 yrs, mortality fell from
10/100,000 to 5/100,000 in the period 1960 to 1975 and assuming the trend
continued -by 1997 it should have approached zero- Similarly, using the
same age groups as in the original paper, in the group 25-34 yrs,
mortality fell from 2.5/100,000 to 1.1/100,000 in the period 1955 to 1965
-by 1997 it should have again approached zero. Since the only new
intervention has been screening, and the mortality is excessive at
5/100,000 screening may have caused upto 2900 extra deaths in 1997. using
the same logic!

Jayant S Vaidya, MS DNB FRCS

Michael Baum, ChM FRCS FRCR

Reference

1. Quinn M, Babb P, Jones J, Allen E. Effect of screening on incidence of
an d mortality from cancer of cervix in England: evaluation based on
routinely collected statistics. BMJ 1999;318:904-908

Competing interests: No competing interests

15 April 1999
Jayant S Vaidya
Honorary Lecturer
University College London