The headline above is the headline of an essay in the New York Times today by my former Dartmouth colleagues Gil Welch, Lisa Schwartz and Steve Woloshin. They address possible consumer confusion over how two studies - one in the New England Journal of Medicine last October and one in the Journal of the American Medical Association this month - could reach two such different conclusions on the possible benefits (and harms) of CT scan screening of smokers for lung cancer.
With their usual clarity, the three authors do a terrific job explaining how this could be - and I won't duplicate what they said here. But here's how they ended the essay:
"But neither study is definitive, because neither was a randomized trial. And both required assumptions. Given the potential benefit (so many people die from lung cancer) and the potential harms (some die from treatments), no one should have to assume anything.
Luckily, two randomized trials are under way — one a Dutch-Belgian collaboration, the other sponsored by the National Cancer Institute. Recent experience, notably with hormone replacement in postmenopausal women, has demonstrated how presuming benefits in the absence of randomized trials can cause real harm. To avoid repeating these mistakes, we should not screen for lung cancer unless the trials demonstrate a reduction in mortality."
Posted by schwitz at March 13, 2007 03:56 PM | TrackBack