SEVERAL points are in order concerning the article by Maurice S. Fox, PhD, that was recently published in JAMA (241:489-494, 1979).
Fox chooses to interpret the Connecticut Tumor Registry's survival and mortality data (unpublished, 1973 to 1975), as indicating that many, if not most, stage I cancers are clinically indolent and biologically insignificant. This, however, is only one of many possible interpretations.
For example, it is equally possible that the increase in incidence of breast cancer is real, and the reason for stable mortality is the fact that there has been a conspicuous downstaging of the disease.
Another possibility is that treatment has improved and that stable mortality is a reflection of that improvement.
Other interpretations and hypotheses could be inferred from these data, and it is clear that no single hypothesis can hold sway over the others without conclusive scientific proof.
Stage at Detection
There is clear proof available