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Journal of the National Cancer Institute Advance Access published online on July 24, 2007
JNCI Journal of the National Cancer Institute, doi:10.1093/jnci/djm080
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© The Author 2007. Published by Oxford University Press.

EDITORIALS

Breast Cancer Trends: A Marriage Between Clinical Trial Evidence and Epidemiology

Donald A. Berry, Peter M. Ravdin

Affiliations of authors: Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, TX (DAB, PMR)

Correspondence to: Donald A. Berry, PhD, Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 447, Houston, TX 77030-4095 (e-mail: dberry@mdanderson.org).

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In this issue of the Journal, Glass et al. (1) report on the changes in screening mammography, menopausal hormone therapy, and breast cancer incidence between 1980 and 2006 in the Kaiser Permanente Northwest (KPNW) health plan. In particular, they report a drop in breast cancer incidence between 2000 and 2004. Similar drops have been reported in other population-based studies (2,3). Considering the various interventions and practices employed by plan participants, the authors conclude that the patterns of screening mammography and menopausal hormone therapy "parallel" breast cancer incidence. They stop short of saying that either screening mammography or decreased menopausal hormone therapy use caused the drop in incidence between 2000 and 2004. But the paralleling implicates the latter.

In observational studies such as those of Glass et al. (1), the question of causation can be inferred but not directly proven. On the other . . . [Full Text of this Article]


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