Failure of researchers, reviewers, editors, and the media to understand flaws in cancer screening studies: Application to an article in Cancer


  • Donald A. Berry PhD

    Corresponding author
    1. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
    • Corresponding author: Donald A. Berry, MD, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030; Fax: (713 563-4243);

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  • See commentary, editorial, and related article on pages 2792–9, 2800–2, and 2839–46, respectively, this issue.

  • See related article What we know and what we think we know: An editor's perspective on a charged debate

  • I acknowledge and congratulate the editor of Cancer, Dr. Fadlo Khuri, for inviting and publishing a commentary while recognizing that it would be critical of a journal under his purview. Dr. Khuri and the Cancer editorial board may well disagree with much of my criticism and with the harshness of my criticisms. Their willingness to have this commentary appear on pages they control represents a truly refreshing attitude for any journal and it bodes well for the future credibility and reputation of Cancer.


Observational studies present inferential challenges. These challenges are acute in cancer screening studies, in which lead-time and length biases are ever present. These biases can make any study worthless. Moreover, a flawed study's impact on the public can be deleterious when its conclusions are publicized by a naïve media. Flawed studies can also make the public learn to be wary of any article or reports of articles claiming to be scientific. Here, the author addresses these and related issues in the context of a study published in Cancer. Cancer 2014;120:2784–2791. © 2014 American Cancer Society.