Blanks R G, Moss S M, Patnick J
Cancer Screening Evaluation Unit, Institute of Cancer Research, Sutton, Surrey, UK.
J Med Screen. 2000;7(4):195-8. doi: 10.1136/jms.7.4.195.
To present results from the NHS breast screening programme (NHSBSP) from 1994 through to 1999 and to examine the extent to which interim targets are being achieved.
Data were collated from all screening programmes in the UK on standard statistical returns. Performance of the screening programme was evaluated using calculated targets based on comparison with the Swedish two counties (STC) randomised controlled trial.
In the early years of screening (1988-1993), the NHS programme was detecting more DCIS but considerably less invasive cancers than expected, based on the STC trial. Since the screening year 1993/94 (1 April to 31 March) the standardised detection ratio (SDR) measure of the detection of invasive cancers has increased by 36% from 0.83 to 1.13. The SDR has been greater than 1 since 1996197 suggesting that the NHSBSP has only been screening as efficiently as the STC trial since this date. Uptake for screening has been relatively stable over time at approximately 75%.
The NHSBSP has made considerable advances in performance since its inception in 1988 and screening uptake and age standardised invasive cancer detection rates are (by 1999) well in excess of targets. The early years of screening were characterised by good uptake but a low sensitivity for the detection of invasive cancers. It is anticipated that the screening programme will have an increasing impact on breast cancer mortality, particularly in the 55-69 year age group over the coming years.
呈现1994年至1999年英国国家医疗服务体系乳房筛查项目(NHSBSP)的结果,并检验中期目标的达成程度。
从英国所有筛查项目的标准统计报表中整理数据。基于与瑞典双郡(STC)随机对照试验的比较,使用计算得出的目标来评估筛查项目的表现。
在筛查早期(1988 - 1993年),基于STC试验,NHS项目检测出的导管原位癌(DCIS)更多,但浸润性癌症比预期少得多。自1993/94筛查年度(4月1日至次年3月31日)以来,浸润性癌症检测的标准化检测率(SDR)从0.83提高到1.13,增长了36%。自1996/97年以来,SDR一直大于1,这表明自那时起NHSBSP的筛查效率才与STC试验相当。随着时间推移,筛查参与率相对稳定,约为75%。
自1988年成立以来,NHSBSP在表现上取得了显著进展,到1999年,筛查参与率和年龄标准化浸润性癌症检测率远超目标。筛查早期的特点是参与率高,但浸润性癌症检测的敏感性低。预计未来几年,该筛查项目对乳腺癌死亡率的影响将越来越大,尤其是在55 - 69岁年龄组。