Mette Lise Lousdal and Henrik Støvring

While organised mammography screening programs were being gradually introduced across various countries, researchers could study the impact of screening on breast cancer mortality by comparing mortality in areas with and without screening. Now that screening has been fully implemented in most Western countries, researchers can only compare women who participate in screening with those who do not participate.

Women who do not participate in screening may seem to be a good choice as a comparison group, as they are not affected by screening. But the question is: can non-participants reflect how breast cancer mortality would have developed in women in general without the introduction of screening?

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