TY - JOUR T1 - US counties with higher rates of breast cancer screening have higher rates of incidence with no concomitant decrease in breast cancer mortality suggesting overdiagnosis JF - Evidence Based Medicine JO - Evid Based Med SP - 201 LP - 201 DO - 10.1136/ebmed-2015-110272 VL - 20 IS - 6 AU - Rebecca A Hubbard Y1 - 2015/12/01 UR - http://ebm.bmj.com/content/20/6/201.abstract N2 - Commentary on: Harding C, Pompei F, Burmistrov D, et al. Breast Cancer Screening, Incidence, and Mortality Across US Counties. JAMA Int Med 2015. Published Online First.The goal of screening mammography is to decrease breast cancer mortality by diagnosing tumours at an earlier, more treatable stage. Meta-analyses of randomised clinical trials have estimated that breast cancer screening results in approximately a 20% decrease in breast cancer mortality.1 However, breast cancer incidence and treatment, as well as performance of screening mammography, have evolved since the conclusion of most of these clinical trials and it is unclear whether screening in the modern era confers the same benefit. Moreover, substantial uncertainty still exists regarding the extent of over diagnosis, the diagnosis of tumours that would not have become clinically apparent within a woman's lifetime in the absence of … ER -