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In Reply:

Pfizer Inc, New London, CT

Period analysis resulted in estimates of 40-year absolute and relative (absolute/population) survival curves. The Methods section of the article by Brenner and Hakulinen¹ states that the estimates are intended to reflect cumulative survival experience for newly diagnosed patients. It is not clear how this differs from "current estimates of long-term survival expectations."

Patients diagnosed 40 years ago did remain at increased risk of death through the 1990s, as demonstrated by relative conditional probabilities by decade. This point does not depend on period analysis, which uses conditional probabilities from the past for projections into the future. To the extent that the past conditional probability estimates will no longer apply, we cannot rely on the accuracy of the projections in the coming decades, empirical observations from previous decades notwithstanding.

The implausible assumption of a cure for death would indeed have provided a striking but irrelevant example. I sincerely hope the breast cancer cure scenario is neither implausible nor irrelevant.

Author’s Disclosures of Potential Conflicts of Interest

The author indicated no potential conflicts of interest.

REFERENCE

1. Brenner H Hakulinen T: Are patients diagnosed with breast cancer below age 50 ever cured? J Clin Oncol 22:432-438, 2004[Abstract/Free Full Text]

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Related Correspondence

• Long-Term Survival and Cure of Patients Diagnosed With Breast Cancer Before Age 50 Years
  Hermann Brenner and Timo Hakulinen
  JCO 2005 23: 1585 [Full Text]

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