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Am J Epidemiol 2003; 157:962-964.
Copyright © 2003 by Johns Hopkins Bloomberg School of Public Health

COMMENTARIES

Invited Commentary: Screening as a Nuisance Variable in Cancer Epidemiology: Methodological Considerations

Marshall M. Joffe

From the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA.

Received for publication December 9, 2002; accepted for publication January 22, 2003.

confounding factors (epidemiology); effect modifiers (epidemiology); neoplasms

The first 150 words of the full text of this article appear below.


   INTRODUCTION
 
A large literature has developed over the last two decades around methods for evaluating the effects and benefits of screening procedures for cancer. In contrast, the role of screening for cancer as a nuisance variable is one that has as yet received little attention. This is unfortunate, because, as Noel Weiss points out in the lead commentary in this issue of the Journal (1), screening procedures can induce distortions in associations between exposures of interest and cancer outcomes and can complicate interpretation of some of these associations. This invited commentary supplements Weiss’s treatment of the topic.


   STUDIES OF CANCER INCIDENCE
 
Studies of risk factors for disease have two purposes: understanding and action. Those who seek to understand cancer etiology use epidemiologic studies to discover risk factors for disease and to fit them into a coherent biologic framework. Those who seek to minimize the burden of disease use these studies to determine the . . . [Full Text of this Article]


   ROLES OF SCREENING: CONFOUNDER, INTERMEDIATE VARIABLE, AND EFFECT MODIFIER
 

   CANCER MORTALITY
 

   OTHER ISSUES
 

   ACKNOWLEDGMENTS
 

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Related articles in Am. J. Epidemiol.:

Adjusting for Screening History in Epidemiologic Studies of Cancer: Why, When, and How to Do It
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Am. J. Epidemiol. 2003 157: 957-961. [Abstract] [FREE Full Text]  

Weiss Responds to "Screening as a Nuisance Variable in Cancer Epidemiology": For Which Aspects of a Study Subject’s Screening History Should We Control?
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Am. J. Epidemiol. 2003 157: 965. [Extract] [FREE Full Text]  



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