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Studies that obtain follow-up data for a short period after screening ends may not sufficiently capture the post-screening deficit of cases and thus can overestimate overdiagnosis.
As a result, there is a deficit of cases in Washtenaw and Livingston counties, and a concomitant clustering of cases in the balance of the study area.
The excesses of cases at both Chinon and Civaux and the deficit of cases at Bruyères/Saclay/Fontenay were no longer significant by these standards.
The screening diagnoses many cancers earlier than they would have been diagnosed in the absence of screening, but after the screening stops, there is a deficit of cases in the screened group and the unscreened group 'catches up'.
On the one hand, none of the sites presented an increased incidence of childhood leukaemia except for Chinon and Civaux and on the other, there was a significant deficit of cases for Bruyères/Saclay/Fontenay.
At St Alban, despite an overall deficit of cases (O=12, E=15.72), there was significant heterogeneity between the four areas under study and the SIR decreased as distance from the site increased.
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The absolute excess of DCIS cases was 10, and the deficit of invasive cases was 28, again suggesting no overdiagnosis of DCIS.
An observed statistically significant deficit of cataract cases may be an occasional finding without any epidemiological relevance.
Since the discussion is mainly driven by the National Cancer Institute (NCI) study,(352) the observation of Marsh and Youk 355) is relevant that the upward trend noted in the NCI study is produced by a deficit of leukemia cases among the unexposed and low exposed workers.
The most notable reduction in incidence is a deficit of observed leukaemia cases among 20to24-year24-yearoldsugh the numbers involved are small (four cases observed as against 9.32 expected).
AVM bleeding was associated with neurological deficit in 30 50% of cases only (Hetts et al. 2014).
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com