van Leiden H A, van Gessel-Dabekaussen A A, van der Maas P J, de Koning H J
Department of Public Health, Erasmus University Rotterdam, The Netherlands.
J Med Screen. 1999;6(2):94-8. doi: 10.1136/jms.6.2.94.
To investigate the impact of the population based breast screening programme on total uptake of mammography in the Netherlands.
The Netherlands; breast screening programme for women aged 50-69; 21,820 women who participated in the 1991-96 Health Interview Survey (HIS).
HIS data linked to data related to the start of the screening programme in different municipalities investigating mammography use, reasons for mammography, and further assessment procedures.
Among women aged 50-69 the percentage who had recently undergone mammography (in the year of the HIS or two years before) increased from 20% in 1991 to 70% in 1996, which was entirely due to screening. The percentage of women in this age group who had had a recent clinical mammogram (outside the screening programme) varied between 8 and 12% and did not change significantly in municipalities without screening. There was no change in the uptake of mammography among women under 50 years of age. Among women over 70 there was only a small increase in this percentage from 6 to 13%, partially due to screening mammograms. In municipalities in which screening had started, precaution is mentioned as a reason for a recent clinical mammogram among women aged less than 70 more often than in municipalities without screening. Furthermore, mammography performed because of complaints is mentioned less in all age groups after the introduction of screening. After a clinical mammogram, further assessment procedures (cytology/needle biopsies 8%, biopsies 10%) were considered necessary about 10 times more often than after a screening mammogram.
Although the screening programme has almost no impact on the frequency of mammography in women who underwent a clinical mammogram, there has been a shift in reasons for these mammograms more towards reasons of prevention. Screening mammograms lead to a much smaller percentage of additional examinations than do clinical mammograms.
调查基于人群的乳腺筛查项目对荷兰乳房X光检查总体接受率的影响。
荷兰；针对50 - 69岁女性的乳腺筛查项目；21820名参与1991 - 1996年健康访谈调查（HIS）的女性。
将HIS数据与不同城市筛查项目启动相关的数据相联系，调查乳房X光检查的使用情况、进行乳房X光检查的原因以及进一步的评估程序。
在50 - 69岁的女性中，近期（在HIS调查当年或之前两年）接受过乳房X光检查的比例从1991年的20%增至1996年的70%，这完全归因于筛查。该年龄组近期进行过临床乳房X光检查（不在筛查项目范围内）的女性比例在8%至12%之间，在未开展筛查的城市中这一比例无显著变化。50岁以下女性的乳房X光检查接受率没有变化。70岁以上女性的这一比例仅从6%小幅增至13%，部分原因是筛查乳房X光检查。在已启动筛查的城市中，与未开展筛查的城市相比，70岁以下女性将预防作为近期进行临床乳房X光检查原因的情况更为常见。此外，在引入筛查后，各年龄组因出现症状而进行乳房X光检查的情况减少。在进行临床乳房X光检查后，约有10倍的可能性认为需要进一步的评估程序（细胞学/针吸活检8%，活检10%），而进行筛查乳房X光检查后则不然。
尽管筛查项目对接受临床乳房X光检查的女性进行乳房X光检查的频率几乎没有影响，但这些乳房X光检查的原因已更多地转向预防。与临床乳房X光检查相比，筛查乳房X光检查导致额外检查的比例要小得多。
