2) This is not a case-cohort study. This is a specific retrospective study designed to address the hypothesis that excess cancers after mammography screening may be related to radiation.
Since we have no explanation for the failure of mammography screening to reduce breast cancer mortality and since mammography screening is ALWAYS associated with an excess of breast cancers, a single study (in the UK) where it is possible to analyze when these cancers occur is relevant. The fact that the same conclusion can be drawn from the effect of mammography screening in the USA and in France (Corcos & Bleyer, NEJM, 2020) removes all doubt on this subject. There have been NO studies since then to suggest that it could be otherwise.
"We so desperately need RCT data for our screening tests. "
Here, you have one:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(85)92204-4/fulltext
Here's why it's best to detect early:
https://jamanetwork.com/journals/jamaoncology/fullarticle/2474438
And here's why mammography screening has not reduced breast cancer mortality.
https://www.biorxiv.org/content/10.1101/238527v1.full
But you are not allowed to talk about that.
Is a 1985 study of breast cancer screening relevant in 2024?
Is a case- cohort useful for anything but hypothesis forming?
1) Yes, since the benefit of early detection has not changed.
https://www.bmj.com/content/381/bmj-2022-074684.long
Fig 4- 7.
2) This is not a case-cohort study. This is a specific retrospective study designed to address the hypothesis that excess cancers after mammography screening may be related to radiation.
Since we have no explanation for the failure of mammography screening to reduce breast cancer mortality and since mammography screening is ALWAYS associated with an excess of breast cancers, a single study (in the UK) where it is possible to analyze when these cancers occur is relevant. The fact that the same conclusion can be drawn from the effect of mammography screening in the USA and in France (Corcos & Bleyer, NEJM, 2020) removes all doubt on this subject. There have been NO studies since then to suggest that it could be otherwise.
Pretty old stuff: RCT of mammograms in today’s world of better treatments needed
There is no reason to believe that better treatments have diminished the benefits of early detection (fig 4-7, https://www.bmj.com/content/381/bmj-2022-074684.long ).