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COMMENTS AND OPINIONS
Breast Cancer Overdiagnosis With Screening Mammography—Reply
Per-Henrik Zahl, MD, PhD;
Jan Mæhlen, MD, PhD;
H. Gilbert Welch, MD, MPH
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In reply
Richards and Weedon-Fekjær et al worry that we have underestimated the confounding effect of HT use. We disagree. Their concern is based on observational studies reporting extremely high breast cancer risk in HT users. Unfortunately, observational data tend to exaggerate both the risks and benefits of HT—a fact clearly demonstrated by the Women's Health Initiative randomized trials (our source for the breast cancer risk associated with HT).
Weedon-Fekjær et al go on to present 2 additional analyses, each of which, they infer, raises questions about ours. First, they apply our method to 5 other Norwegian counties where screening started in 2001 and find little difference between the screened and control group. Because this is 5 years later than our analysis, they have inadvertently introduced the reverse problem: HT use is higher in their control group . . . [Full Text of this Article]
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