Comment & Response |

Differences in Breast Cancer Survival by Race

Charles Ford Harding, AB1; Francesco Pompei, PhD2; Richard Wilson, DPhil2
[+] Author Affiliations
1Independent data scientist (self-employed), Seattle, Washington
2Department of Physics, Harvard University, Cambridge, Massachusetts
JAMA. 2013;310(22):2456-2457. doi:10.1001/jama.2013.281072.
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To the Editor Dr Silber and colleagues1 reported survival differences among black and white women with breast cancer. However, screening overdiagnosis may weaken the results of this and prior studies on the topic.

For example, cases detected through screening mammography are sometimes diagnosed as breast cancer even though they would never be noticed otherwise. These overdiagnoses can lead to unnecessary treatments.2 Recent studies have prompted disagreement about the extent of overdiagnosis.3 Despite this attention, the effect of overdiagnosis on survival disparities is unclear.


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December 11, 2013
Jeffrey H. Silber, MD, PhD; Paul R. Rosenbaum, PhD; Kevin R. Fox, MD
1Center for Outcomes Research, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
2Department of Statistics, University of Pennsylvania, Philadelphia
3Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia
JAMA. 2013;310(22):2457. doi:10.1001/jama.2013.281075.
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