Sir,
I find the response of Morrell et al (2017) to my Comment unconvincing. The reduction in breast cancer mortality that has occurred in many countries (including New Zealand) is not related to the introduction of mammography screening, but to the introduction of treatment advances. This reduction was not instantaneous, but followed a five-year lag, as would be expected.
We should not continue with the fiction that mammography screening is the solution for all evils related to breast cancer mortality. It is time to recognise that other strategies, including Early Diagnosis as recommended by WHO (2017), are preferable options.
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References
Morrell S, Roder D, Taylor R (2017) Reply to ‘Comment on ‘Effect of population breast screening on breast cancer mortality up to 2005 in England and Wales: an individual-level cohort study’’. Br J Cancer (e-pub ahead of print 21 September 2017; doi:10.1038/bjc.2017.328).
WHO (2017) Guide to Cancer Early Diagnosis.. World Health Organization: Geneva, Switzerland.
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Miller, A. Response to Morrell et al's reply. Br J Cancer 117, e8 (2017). https://doi.org/10.1038/bjc.2017.322
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DOI: https://doi.org/10.1038/bjc.2017.322
