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					2                                                                                                                                     Austin


   The important point is that cervical cancer screening saves   attributed by the authors to non-systematic screening, the
lives, and because of innovative analyses such as that in the    total is about 75%. Given the considerable uncertainty
Peto paper we can quantify the number of deaths prevented.       associated with such estimates, this figure agrees reasonably
Furthermore, the data presented in that paper provide            well with their statement that 80% or more of cervical
additional evidence that screening is beneficial. Table 1         cancer deaths are preventable by screening. Thus, screening
displays the ratio of the actual mortality rate to the fitted     for cervical cancer was already preventing deaths and the
rate obtained from the Poisson model for the period              introduction of the national screening programme has
1988–2002. I have added my estimate of the number of             accelerated the process.
deaths prevented since the introduction of the national                                                               Harland Austin
screening programme in 1988 to Table 1.                                    Professor of Epidemiology, Rollins School of Public Health,
   In the 15-year period from 1988 to 2002, I estimate the                                   Emory University, Atlanta, Georgia, USA
total number of prevented cervical cancer deaths as 11,136,
to be compared with 19,374 deaths actually observed. Thus,
the proportion prevented is:                                     REFERENCES
                                                                 1   Parkin DM, Nguyen-Dinh X, Day NE. The impact of screening on the
                         11; 136                                     incidence of cervical cancer in England and Wales. Br J Obstetr Gynaecol
                                       ¼ 0:36:
                   ð11; 136 þ 19; 374Þ                               1985;92:150–7
                                                                 2   Levi F, Lucchini F, Negri E, Franceschi S, la Vecchia C. Cervical cancer
 These prevented deaths are attributable to the national             mortality in young women in Europe: patterns and trends. Eur J Cancer
                                                                     2000;36:2266–71
screening programme per se, rather than to screening in          3   Peto J, Gilham C, Fletcher O, Matthews FE. The cervical cancer epidemic
general. If you combine this prevented fraction to the 0.4           that screening has prevented in the UK. Lancet 2004;364:249–56




Obituary
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It is with great sadness that we notify readers of the death     for thirteen years until illness necessitated his resignation. He
from prostate cancer of Professor David Brock, FRSE, on          made outstanding contributions in biochemical and mole-
25 November 2004. David was a Founding member                    cular genetics, much of which had with major implications
of the Editorial Board of the Journal and worked with us         for medical screening. He will long be remembered.




Journal of Medical Screening   2005   Volume 12   Number 1                                                           www.jmedscreen.com