ABSTRACT
The Health Insurance Plan (HIP) project was the first trial ever to test the efficacy of screening for cancer at any site. It was initiated in December 1963 to determine ‘whether periodic breast screening with mammography and clinical examination of the breast holds substantial promise for lowering mortality in the female population from breast cancer’. Sixty-two thousand women of 40-64 years of age receiving their medical care from the Health Insurance Plan of New York State were individually randomized either to be invited to participate in four annual screens or to form a control group. The trial ended in 1986 allowing breast cancer deaths to be ascertained during 15-20 years from entry. Early reports that screen-detected cancers were less likely to have involved lymph nodes and had longer survival when adjusted for lead-time were followed by mortality entry to the trial there was a reduction of breast cancer deaths of 30% in the study group, which at 18 years was still evident at 23%. This book presents full details of all aspects of this trial; additional studies confirmed that the analyses were free from bias.
