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We thank Drs Chlebowski, Nikolaenko and Anderson for their comments.1
We have previously reviewed2 the article published by Chlebowski and his colleagues in the New England Journal of Medicine,3 and the claim that it documented that “mammography use was similar in the hormone-therapy and placebo groups … before and after the intervention [i.e. the Women's Health Initiative (WHI) clinical trial]” is incorrect. Only the percentages of breast cancer that were detected by mammography were documented.
In a subsequent article Chlebowski et al. 4 stated that “mammography frequency was comparable in the two randomization groups during the original trial period … (annualized percentage, 80% for hormone vs 80% for placebo). In the reconsenting population [i.e. women who consented for long-term follow-up after the protocol-specified trial period ended] … the percentages of women with one or more mammograms were also comparable … (86% for hormone vs 86% placebo [sic])”. However, the annual numbers, or the rates, of mammography among the women who stopped their treatments, either during the trial or thereafter, …
Footnotes
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Competing interests Samuel Shapiro, John Stevenson, Henry Burger, Alfred Mueck and Anne Gompel presently consult, and in the past have consulted, with manufacturers of products discussed in this article. Richard Farmer has consulted with manufacturers in the past.
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Provenance and peer review Commissioned; internally peer reviewed.