Abstract A common goal of epidemiologic research is to study the association between a certain exposure and a certain outcome, while controlling for important covariates. This is often done by fitting a restricted mean model for the outcome, as in generalized linear models (GLMs) and in...

Abstract Public policies promoting ‘screening’ for a cancer, while directly bearing on the cancer’s early diagnosis and treatment, are really aimed at reducing mortality from the cancer in the populations in question. In the adoption, or continuation, of such a policy, the policy-makers...

Abstract From the writings in medical journals and newspapers, for many decades already, it has seemed uncertain whether programs of mammographic screening reduce mortality from breast cancer. Reviewers of the evidence, in the Cochrane Collaboration in particular, have repeatedly concluded that...

Abstract I’d like to highlight some of the points about research on mammography screening that Dr. Miettinen and I agree on. But I disagree with the main point he tries to make.

Abstract Randomized controlled trials have been the mainstay of high-level evidence for or against cancer screening strategies. However, simple proof of reduction in cause-specific mortality is not enough for policymaking, particularly in the last 10 years. Today’s clinical and public health...

Abstract Professor Miettinen offers a scathing critique of the criteria used by official bodies to decide for whom and how often breast cancer screening should be offered ( Miettinen, 2015 ). He notes that these bodies often simply synthesize the results of prior randomized clinical trials with...