Response to Dr. Shelton's Letter on Breast Cancer Risks
Author Information
Author(s): D.B. Thomas, E.A. Noonan
Primary Institution: Fred Hutchinson Cancer Research Center
Hypothesis
The increased relative risk of breast cancer in developing countries may be due to biases in control selection.
Conclusion
The authors argue that their findings of increased breast cancer risk among oral contraceptive users in developing countries are not due to the biases suggested by Dr. Shelton.
Supporting Evidence
- The prevalence of oral contraceptive use did not vary significantly across different diagnostic categories of controls.
- Data collection began over 10 years ago, reducing the likelihood of recent disease status affecting results.
- Findings from other studies in China and Costa Rica support the increased risk of breast cancer in oral contraceptive users.
Takeaway
The study suggests that using oral contraceptives might increase breast cancer risk, especially in developing countries, but the authors believe their results are valid despite concerns about bias.
Methodology
The authors analyzed data on breast cancer risk and oral contraceptive use, considering various potential confounding factors.
Potential Biases
The authors believe that the biases suggested by Dr. Shelton do not adequately explain their findings.
Limitations
The authors did not provide detailed information on all controls' medical histories due to space constraints.
Participant Demographics
The study involved women from both developed and developing countries with a range of diseases.
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