Tyler J. VanderWeele

Research to Inform Public Policies on Screening for a Cancer: A Critical Disquisition Followed by Invited Commentaries

De Gruyter | Published online: October 27, 2015

In this volume of Epidemiologic Methods we have included a number of contributions relevant to an important topic within public health and epidemiology, that of breast cancer screening research. During the fall of 2014, Professor Olli Miettinen visited the Harvard School of Public Health to present a series of seminars. One of those seminars was on the topic of research concerning the mortality benefits of breast cancer screening. During his visit, Professor Miettinen proposed to publish, in this journal, an article, to be accompanied by a series of invited commentaries, on this topic, specifically focused upon research relevant to the estimates that experts give to policy-makers about the mortality benefits from particular policies promoting screening. The editors of the journal agreed that this would indeed be of potential importance and it is this article, with commentaries, and rejoinder, that we here present in this volume of the journal.

Professor Miettinen’s paper argues that there is a misguidedness in breast cancer screening research and in its use in informing policy guidelines because of the choice of the relevant effect parameter. He argues that research with the wrong choice of design parameter has been misinforming public policies. A series of six invited commentaries, by Johann Steurer, Karin Huwiler and co-authors, Diana Petitti, Eduardo Franco, Noel Weiss, and James Robins, follow. These commentaries offer reflections on Miettinen’s lead article but also often touch upon various other and broader aspects of the breast cancer screening debate. The exchange concludes with Miettinen’s rejoinder.

Towards the end of his lead article, and reiterated again in his rejoinder, Miettinen, notes that:

We epidemiological researchers and, especially, theoreticians thereof have mostly been missing in action on the “screening” front of the “war on cancer,” inexplicably and unjustifiably. We, therefore, are largely responsible for misguided research continually misinforming public policies on “screening” for cancers…

We hope that this exchange will not only help stimulate clearer thinking and better research practices, but will also contribute to more active engagement of epidemiological researchers and theoreticians in this important area of public health research.

Published Online: 2015-10-27
Published in Print: 2015-12-1

©2015 by De Gruyter