Sarkeala Tytti, Hakama Matti, Saarenmaa Irma, Hakulinen Timo, Forsman Hakan, Anttila Ahti
Finnish Cancer Registry, Helsinki, Finland.
Int J Cancer. 2006 Jan 1;118(1):174-9. doi: 10.1002/ijc.21310.
We assessed the episode sensitivity of the Finnish mammography program for women aged 50-59 (partly 60-64) years and explored associations between the episode sensitivity and the screening process indicators from 1991 to 1999. For the study period, data were available from 10 screening centers. Records of 721,000 screening visits were linked to the files of the nationwide Finnish Cancer Registry from 1991 to 2001 at an individual level. The rates of screen-detected and interval breast cancers were calculated at the first and at the subsequent screens. The episode sensitivity was determined by contrasting the incidence of interval cancers with the expected population incidence rate without screening (incidence method) and as a proportion of interval cancers out of all cancers detected (detection method). At the subsequent screens, the episode sensitivity determined by the incidence method was 54% and by the detection method 65%. The sensitivity 0-11 and 12-23 months after the screening was 70% and 38%, respectively. The episode sensitivity decreased toward the end of the study period and increased with age. The center-specific sensitivity increased 13% per 1% absolute increase in the recall rate. In general, our study provides further information on the effectiveness of screening programs. The sensitivity estimates were comparable with those from other European service screening programs. The variability in the episode sensitivity suggests potential for variations in the future screening outcome.
我们评估了芬兰乳腺钼靶筛查项目对50 - 59岁（部分为60 - 64岁）女性的筛查敏感性，并探讨了1991年至1999年间筛查敏感性与筛查过程指标之间的关联。在研究期间，可获取来自10个筛查中心的数据。1991年至2001年期间，721,000次筛查就诊记录在个体层面与芬兰全国癌症登记处的档案相链接。计算了首次及后续筛查中筛查发现的乳腺癌和间期癌的发生率。通过将间期癌的发生率与未进行筛查时预期的人群发生率进行对比（发生率法）以及将间期癌占所有检测到的癌症的比例（检测法）来确定筛查敏感性。在后续筛查中，通过发生率法确定的筛查敏感性为54%，通过检测法为65%。筛查后0 - 11个月和12 - 23个月的敏感性分别为70%和38%。筛查敏感性在研究期结束时下降，并随年龄增长而增加。召回率每绝对增加1%，各中心的敏感性增加13%。总体而言，我们的研究提供了关于筛查项目有效性的更多信息。敏感性估计值与其他欧洲服务筛查项目的相当。筛查敏感性的变异性表明未来筛查结果可能存在差异。
