Jensen Anni Ravnsbaek, Garne Jens Peter, Storm Hans Henrik, Engholm Gerda, Möller Torgil, Overgaard Jens
Centre for Cancer Documentation, Department of Experimental Clinical Oncology, Danish Cancer Society, Aarhus University Hospital, Denmark.
Acta Oncol. 2004;43(8):719-26. doi: 10.1080/02841860410002789.
Breast cancer survival differs 9 percentage points between the neighbouring countries of Denmark and Sweden. The authors' aim was to analyse whether this was caused by early detection in Sweden. The extent of disease and outcome was compared in two population-based breast cancer cohorts in 1983-1989. Breast cancer management was decentralized in Denmark without mammography screening whereas treatment in Sweden was centralized and the population partly screened. Ten- and 15-year relative survival was 15% and 6% higher in Sweden (p<0.001) with corresponding differences in crude and disease-specific survival. Stage distribution was significantly more favourable in the Swedish cohort. In multivariate analysis age, tumour size, extent of axillary surgery, and spread affected survival; however, the impact of region persisted (p<0.001). Reanalysis without screening-detected patients only slightly affected the impact of region. It was concluded that early detection had significant impact on survival but other regional differences might be of importance.
丹麦和瑞典这两个邻国的乳腺癌生存率相差9个百分点。作者的目的是分析这是否是由瑞典的早期检测所致。对1983 - 1989年两个基于人群的乳腺癌队列中的疾病程度和预后进行了比较。丹麦的乳腺癌管理是分散的，没有乳腺钼靶筛查，而瑞典的治疗是集中的，并且部分人群接受了筛查。瑞典的10年和15年相对生存率分别高出15%和6%（p<0.001），粗生存率和疾病特异性生存率也有相应差异。瑞典队列中的分期分布明显更有利。多因素分析显示年龄、肿瘤大小、腋窝手术范围和扩散情况影响生存率；然而，地区的影响仍然存在（p<0.001）。仅对非筛查发现的患者进行重新分析，对地区的影响只是略有改变。得出的结论是，早期检测对生存率有显著影响，但其他地区差异可能也很重要。
