Jensen Anni R, Garne Jens P, Storm Hans H, Ewertz Marianne, Cold Søren, Alvegaard Thor, Overgaard Jens
Centre for Cancer Documentation, Department of Experimental Clinical Oncology, Danish Cancer Society, Denmark.
Acta Oncol. 2003;42(7):701-9. doi: 10.1080/02841860310010556.
Comparisons between the Danish and Swedish Cancer Registry revealed a 9% difference in 5-year survival for breast cancer patients diagnosed between 1983 and 1989. The purpose of this study was to determine whether previous differences in survival and stage still exist or whether the Danish figures approach those of the Swedish registry. Complete population-based cohorts of patients with breast cancer in the years 1996-1997 from well-defined areas in Denmark and Sweden were compared. The study regions were a Danish (Funen) and a Swedish (Malmö) county with mammography screening and two Danish counties without screening. No difference in extent of disease or survival was observed between screening areas regardless of country. However, there were significant differences in stage distribution and survival between screening populations and Danish non-screening populations, to the benefit of populations provided with a screening programme. Five-year survival was 5-6%, higher in screening populations than in Danish non-screening counties. Corresponding disease-specific survival enhanced the difference. In a multivariate analysis increasing age, tumour size and stage decreased survival. Adjusting for these factors eliminated differences in survival according to country/county. Survival difference could be attributed to early diagnosis and favourable stage in populations offered mammography screening and was not related to nation. Denmark may, through early detection, approach the beneficial stage distribution and survival observed in Sweden.
丹麦癌症登记处与瑞典癌症登记处之间的比较显示，1983年至1989年期间确诊的乳腺癌患者5年生存率存在9%的差异。本研究的目的是确定以前在生存率和分期方面的差异是否仍然存在，或者丹麦的数据是否接近瑞典登记处的数据。对1996 - 1997年丹麦和瑞典明确区域内基于人群的乳腺癌患者完整队列进行了比较。研究区域包括丹麦的一个县（菲英岛）和瑞典的一个县（马尔默），这两个县都有乳腺钼靶筛查，以及两个没有筛查的丹麦县。无论哪个国家，筛查地区之间在疾病范围或生存率方面均未观察到差异。然而，筛查人群与丹麦非筛查人群之间在分期分布和生存率方面存在显著差异，筛查项目对人群有益。5年生存率为5 - 6%，筛查人群高于丹麦非筛查县。相应的疾病特异性生存率扩大了这种差异。在多变量分析中，年龄增加、肿瘤大小和分期增加会降低生存率。对这些因素进行调整后，消除了根据国家/县划分的生存率差异。生存差异可归因于接受乳腺钼靶筛查人群的早期诊断和有利分期，与国家无关。丹麦或许可以通过早期检测，接近瑞典所观察到的有益分期分布和生存率。
