Grünfeld K, Horwitz O, Lysgaard-Hansen B
Am J Epidemiol. 1975 Apr;101(4):265-75. doi: 10.1093/oxfordjournals.aje.a112094.
During the years 1961-1971, a total of 3696 women died in Denmark from cervical cancer. The annual mortality per 1000 was 0.23 and was constant in this period. The mortality was 0.30 in the Capital where a mass screening program has existed since 1968; in the Provinces, where screening was negligible, the rate was 0.21; the time trend was also constant. The mortality was low in youth, reaching a level of 0.30 around 45 years. Single women had the lowest mortality; among married women it was double, among widows 2-4 times higher, among divorcees 4 times. Within the marital groups, the Capital had higher or the same rates as the Provinces, except for divorcees in the Provinces who had higher rates. The lowest socioeconomic groups had the highest death rates at young ages. The effects of a total vs. an age-specific case-finding program have been estimated under three circumstances, namely that mass screening could reduce the cervical cancer mortality by 10%, by 50%, or by 100%. The impact on the public's health has been evaluated by relating the hypothetically prevented cervical cancer deaths to all cancer deaths and to deaths from all causes. The general population was subdivided by age, marital status and residence and ranked according to cervical cancer mortality. These data were used to design programs which would minimize the number of examinees and maximize the number of prvented deaths.
1961年至1971年期间,丹麦共有3696名女性死于宫颈癌。在此期间,每1000人的年死亡率为0.23,且保持不变。自1968年起开展大规模筛查项目的首都地区,死亡率为0.30;筛查可忽略不计的省份,死亡率为0.21;时间趋势也保持不变。青年女性的死亡率较低,45岁左右达到0.30的水平。单身女性的死亡率最低;已婚女性的死亡率是单身女性的两倍,寡妇的死亡率高2至4倍,离婚女性的死亡率则高4倍。在婚姻群体中,除了省份中离婚女性死亡率较高外,首都地区的死亡率与省份相当或更高。社会经济地位最低的群体在年轻时死亡率最高。在三种情况下,即大规模筛查可将宫颈癌死亡率降低10%、50%或100%,分别估计了全面病例发现项目与特定年龄病例发现项目的效果。通过将假设预防的宫颈癌死亡人数与所有癌症死亡人数以及所有原因导致的死亡人数相关联,评估了对公众健康的影响。将普通人群按年龄、婚姻状况和居住地进行细分,并根据宫颈癌死亡率进行排名。这些数据被用于设计项目,以尽量减少受检人数,并最大限度地增加预防死亡人数。