CORRESPONDENCE Re: Effi cacy of Breast Cancer Screening in the Community

The case – control study of mammog-raphy screening by Elmore and colleagues ( 1) raises some interesting points. We agree with the sentiment in the accompa-nying editorial by Harris ( 2) that evalua-tion of breast screening in the community is challenging and worthy of further re-search. We see some of those methodo-logic challenges in the analysis by Elmore et al. The fact that women who died from breast cancer, 75 % of whom had tumors larger than 2 cm, had screening exposures similar to those of the population-based control subjects suggests that the screen-ing programs were ineffective and/o