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Journal of Clinical Oncology, Vol 23, No 1 (January 1), 2005: pp. 244 © 2005 American Society of Clinical Oncology. DOI: 10.1200/JCO.2005.05.900
Validity of Short-Term Consequences of Cancer Prevention and Screening Activities? ,Department of General Practice, University of Copenhagen, Panum Institute, Copenhagen, Denmark To the Editor: We have read with interest the article by Cullen et al,1 in which more than 200 studies about cancer prevention and screening have been reviewed. However, we find it necessary to make some comments in light of our recently published review of the adequacy of measurement of short-term and long-term consequences of false-positive screening mammography.2 In their review, Cullen et al find that "the overwhelming majority of research indicated that short-term effects were transient." However, in the area of consequences of false-positive screening, there is very good evidence, including studies that use community controls, that a false-positive screening does result in measurable short-term adverse consequences that are apparent for at least 1 week after individuals are told that breast cancer has not been detected.3 Like Cullen et al, we found heterogeneity in outcome measurements in the field of breast cancer screening,2 but we found no evidence of any valid instruments that could lead to the conclusion that the adverse short-term consequences are transient.2 Our review found that the most adequate questionnaire to measure short-term consequences of false-positive screening is the Psychological Consequences Questionnaire,4 though it may have problems with content validity when used for measuring the long-term consequences. We also found no valid questionnaires measuring long-term consequences of false-positive screening mammography, leading us to propose that any current conclusions about the long-term consequences of false-positive results of screening mammography must remain tentative. In the review of Cullen et al, we missed a discussion on the validity of the battery of measures they have reviewed, and would have appreciated a more critical review of the validity of the different outcome measurements. We do not have in-depth knowledge of the other areas covered by Cullen et al, as our review focused on instruments measuring consequences of false-positive screening mammography. We are concerned that the validity of the outcome measurements used in the other areas is just as inadequate as in the area of screening mammography. Authors' Disclosures of Potential Conflicts of Interest The authors indicated no potential conflicts of interest. NOTES REFERENCES
1. Cullen J, Schwartz MD, Lawrence WF, et al: Short-term impact of cancer prevention and screening activities on quality of life. J Clin Oncol 22:943-952, 2004 2. Brodersen J, Thorsen H, Cockburn J: The adequacy of measurement of short and long-term consequences of false-positive screening mammography. J Med Screen 11:39-44, 2004[CrossRef][Medline] 3. Cockburn J, Staples M, Hurley SF, et al: Psychological consequences of screening mammography. J Med Screen 1:7-12, 1994[Medline] 4. Cockburn J, De LT, Hurley S, et al: Development and validation of the PCQ: A questionnaire to measure the psychological consequences of screening mammography. Soc Sci Med 34:1129-1134, 1992 Related Article
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Copyright © 2005 by the American Society of Clinical Oncology, Online ISSN: 1527-7755. Print ISSN: 0732-183X
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Deceased 
