Tange Ulla Brix, Hirsch Fred R, Jensen Maj-Britt, Olsen Anne Helene, Blichert-Toft Mogens, Rank Fritz E, Vejborg Ilse M M, Mouridsen Henning, Lynge Elsebeth
Onkologisk Klinik 5073, Finsencentret, H:S Rigshospitalet, DK-2100 København.
Ugeskr Laeger. 2002 Feb 18;164(8):1048-52.
Biennial service mammography screening for breast cancer has been offered to women aged 50-69 years in the municipality of Copenhagen since 1991. We report the results of the first three invitation rounds.
Data were collected from the Copenhagen service mammography screening database and other Danish registers.
The average participation rate during the first three invitation rounds was 66%. The breast cancer detection rate was 10/1,000 screened in the first invitation round and 5/1,000 in the consecutive rounds. The probability of a false positive mammography was 6% at the prevalent screen, and this was reduced to 3% at incidence screens. Fifty-two cases of interval cancer were seen after the first invitation round. The expected number was 152, which gives a proportional interval cancer rate of 0.34. The sensitivity was 86% and the specificity 94% after the first round.
The detection rate of breast cancer was high, especially in the prevalence round. The trend in the incidence of breast cancer at the subsequent rounds was similar to that before screening, which indicates that mammography screening does not lead to any greater over-diagnosis. The rate of false positive mammography was high at the initial screening round, but was acceptable at subsequent rounds, and a false positive mammography does not seem to have affected participation in subsequent rounds. The Copenhagen screening programme conforms to international quality assurance guidelines for process evaluation.
自1991年起,哥本哈根市已为50至69岁的女性提供每两年一次的乳腺癌乳腺钼靶筛查服务。我们报告了前三轮邀请筛查的结果。
数据收集自哥本哈根乳腺钼靶筛查服务数据库及其他丹麦登记处。
前三轮邀请筛查的平均参与率为66%。首轮邀请筛查中乳腺癌检出率为每1000名受检者中有10例,后续轮次为每1000名中有5例。在现患筛查中,乳腺钼靶假阳性概率为6%,在发病筛查中降至3%。首轮邀请筛查后发现52例间期癌。预期数量为152例,间期癌比例为0.34。首轮筛查后敏感性为86%,特异性为94%。
乳腺癌检出率较高,尤其是在现患筛查轮次。后续轮次乳腺癌发病率趋势与筛查前相似,这表明乳腺钼靶筛查不会导致更多的过度诊断。首轮筛查时乳腺钼靶假阳性率较高,但在后续轮次可接受,且假阳性结果似乎未影响后续轮次的参与率。哥本哈根筛查项目符合国际过程评估质量保证指南。