Correcting for lead time and length bias in estimating the effect of screen detection on cancer survival.

Determination of survival time among persons with screen-detected cancer is subject to lead time and length biases. The authors propose a simple correction for lead time, assuming an exponential distribution of the preclinical screen-detectable period. Assuming two latent categories of tumors, one of which is more prone to screen detection and correspondingly less prone to death from the cancer in question, the authors have developed a strategy of sensitivity analysis for various magnitudes of length bias. Here they demonstrate these methods using a series of 25,962 breast cancer cases (1988-2004) from the West Midlands, United Kingdom.

[1]  S. Duffy,et al.  Overdiagnosis, Sojourn Time, and Sensitivity in the Copenhagen Mammography Screening Program , 2006, The breast journal.

[2]  D. Evans,et al.  Screening younger women with a family history of breast cancer--does early detection improve outcome? , 2006, European journal of cancer.

[3]  Odd O Aalen,et al.  Estimating mean sojourn time and screening test sensitivity in breast cancer mammography screening: new results , 2005, Journal of medical screening.

[4]  A. Miller,et al.  Estimation of age‐specific sensitivity and sojourn time in breast cancer screening studies , 2005, Statistics in medicine.

[5]  L. Tabár,et al.  Quantifying the potential problem of overdiagnosis of ductal carcinoma in situ in breast cancer screening. , 2003, European journal of cancer.

[6]  L. Tabár,et al.  Correcting for non‐compliance bias in case–control studies to evaluate cancer screening programmes , 2002 .

[7]  L. Tabár,et al.  The Swedish Two-County Trial twenty years later. Updated mortality results and new insights from long-term follow-up. , 2000, Radiologic clinics of North America.

[8]  L. Tabár,et al.  Update of the Swedish two-county program of mammographic screening for breast cancer. , 1992, Radiologic clinics of North America.

[9]  S. Duffy,et al.  Modelling the analysis of breast cancer screening programmes: sensitivity, lead time and predictive value in the Florence District Programme (1975-1986). , 1991, International journal of epidemiology.

[10]  J D Habbema,et al.  A model for breast cancer screening , 1990, Cancer.

[11]  S. Moss,et al.  Randomised controlled trial of faecal-occult-blood screening for colorectal cancer , 1989, The Lancet.

[12]  L. Stitt,et al.  Evaluating the survival of cancer cases detected by screening. , 1987, Statistics in medicine.

[13]  N. Day,et al.  Simplified models of screening for chronic disease: estimation procedures from mass screening programmes. , 1984, Biometrics.

[14]  Marvin Zelen,et al.  On the theory of screening for chronic diseases , 1969 .

[15]  S. Shapiro,et al.  Lead time gained by diagnostic screening for breast cancer. , 1968, Journal of the National Cancer Institute.