Cancer Stage vs Mortality End Points in Randomized Clinical Trials of Cancer Screening

To the Editor A recent study provided a robust analysis of the association between the reduction in stage III to IV cancer diagnoses and overall survival gains in historical cancer screening trials, and the accompanying Editorial added an important epidemiological perspective. However, the relationship between cancer stage at diagnosis and survival is not static. Data from the studies examined, many of which were initiated 30 to 40 years ago, are of questionable relevance in the modern era.