Early detection versus prevention in colorectal cancer screening: Methods estimates and public health implications

The percentage of mortality reduction due to prevention via the removal of adenomatous polyps or to early detection using comparison of survivals in intervention and usual‐care groups is flawed by lead time. Herein, a simple alternative algorithm is used and approximately 79% of averted colorectal cancer deaths are found to be due to prevention in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. Some implications for public health are discussed. See also pages 4815‐22.