Ballard-Barbash R, Klabunde C, Paci E, Broeders M, Coleman E A, Fracheboud J, Bouchard F, Rennert G, Shapiro S
National Cancer Institute, Bethesda, MD 20892-7344, USA.
Eur J Cancer Prev. 1999 Oct;8(5):417-26. doi: 10.1097/00008469-199910000-00007.
Following clinical trial evidence of mammography screening's efficacy and effectiveness, data are needed from organized population-based programmes to determine whether screening in these programmes results in breast cancer mortality reductions comparable to those demonstrated in controlled settings. The International Breast Cancer Screening Network (IBSN) conducted two international programme assessments: in 1990 among nine countries and in 1995 among 22 countries, obtaining information on the organization and process for screening within breast cancer screening programmes. This manuscript describes procedures for recruitment, service delivery, interpretation and communication of results, case ascertainment, and quality assurance. Practices in more established programmes are compared with pilot programmes. Each IBSN country defined a unique programme of population-based breast cancer screening. Some programmes were sub-national rather than national in scope, while others were in pilot stages of development. Screening took place in dedicated centres in established programmes and in both dedicated and general radiology centres in pilot programmes. Although most countries used personal invitation systems to recruit women to screening, other recruitment mechanisms were used. Most countries used two-view mammography in their screening programmes. About half had implemented independent double reading of mammograms, considering it a key component of high-quality mammography screening. In conclusion, diversity exists in the organization and delivery of screening mammography internationally. Quality assurance activities are a priority and are being evaluated in the IBSN.
在获得乳腺钼靶筛查有效性和成效的临床试验证据之后，需要来自基于人群的有组织项目的数据，以确定这些项目中的筛查是否能使乳腺癌死亡率降低，且降低幅度与在对照环境中所证明的相当。国际乳腺癌筛查网络（IBSN）进行了两项国际项目评估：1990年在9个国家开展，1995年在22个国家开展，获取了乳腺癌筛查项目中筛查的组织和流程方面的信息。本手稿描述了招募、服务提供、结果解读与沟通、病例确诊以及质量保证的程序。将更成熟项目的做法与试点项目进行了比较。每个IBSN国家都定义了一个独特的基于人群的乳腺癌筛查项目。一些项目范围是在国家以下层面而非全国范围，而其他项目则处于发展的试点阶段。在成熟项目中，筛查在专门的中心进行；在试点项目中，筛查在专门的放射中心和普通放射中心均可进行。尽管大多数国家使用个人邀请系统来招募女性参与筛查，但也采用了其他招募机制。大多数国家在其筛查项目中使用双视角乳腺钼靶检查。约一半国家已实施乳腺钼靶片独立双人阅片，将其视为高质量乳腺钼靶筛查的关键组成部分。总之，国际上乳腺钼靶筛查的组织和实施存在多样性。质量保证活动是优先事项，IBSN正在对其进行评估。
