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基于人群的乳腺癌筛查项目中累积假阳性召回率及其与参与者相关因素的关联。

Cumulative false positive recall rate and association with participant related factors in a population based breast cancer screening programme.

作者信息

Castells Xavier, Molins Eduard, Macià Francesc

机构信息

Evaluation and Clinical Epidemiology Department,Institut Municipal d'Investigació Mèdica (IMIM-IMAS), Passeig Marítim 25-29, 08003, Barcelona, Spain.

出版信息

J Epidemiol Community Health. 2006 Apr;60(4):316-21. doi: 10.1136/jech.2005.042119.

Abstract

STUDY OBJECTIVE

To investigate the cumulative false positive recall rate throughout the period of participation in a population based breast cancer screening programme and to examine its association with women related factors.

DESIGN

Analysis of a database to estimate the cumulative false positive recall rate after 10 biennial mammograms in a cohort of women. Cumulative risk after 10 rounds was calculated by projecting forward the information available on the four rounds. Logistic regression was used to evaluate the association between the cumulative risk of false positive recall and women related factors.

SETTING

Population based breast cancer screening programme in Barcelona City (Spain).

PARTICIPANTS

8502 women aged 50-69 years who participated in four consecutive screening rounds. Eligible women had received a mammogram in the first screening round between 1 December 1995 and 31 December 1996.

MAIN RESULTS

The false positive recall rate in the first screening for women who entered the screening programme at the age of 50-51 years was assessed at 10.6% (95% CI 8.9, 12.3). In the second screening this risk decreased to 3.8% (95% CI 2.7, 4.9) and remained almost constant in subsequent rounds. After 10 mammograms, the cumulative false positive recall rate was estimated at 32.4% (95% CI 29.7, 35.1). The factors associated with a higher cumulative risk of false positive recall were: previous benign breast disease (OR = 8.48; CI 7.39, 9.73), perimenopausal status (OR = 1.62; CI 1.12, 2.34), body mass index above 27.3 (OR = 1.17; CI 1.02, 1.34), and age 50-54 years (OR = 1.15; CI 1.00, 1.31).

CONCLUSIONS

One third of women could have at least one false positive recall over 10 biennial screens. Women participating in screening programmes should be informed about this risk, especially those with associated factors.

摘要

研究目的

调查在基于人群的乳腺癌筛查项目参与期间的累积假阳性召回率,并研究其与女性相关因素的关联。

设计

对一个数据库进行分析,以估计一组女性在接受10次两年一次的乳房X光检查后的累积假阳性召回率。通过向前推算四轮可用信息来计算10轮后的累积风险。使用逻辑回归来评估假阳性召回累积风险与女性相关因素之间的关联。

地点

西班牙巴塞罗那市基于人群的乳腺癌筛查项目。

参与者

8502名年龄在50 - 69岁之间且连续参加四轮筛查的女性。符合条件的女性在1995年12月1日至1996年12月31日的第一轮筛查中接受了乳房X光检查。

主要结果

在50 - 51岁进入筛查项目的女性中,首次筛查时的假阳性率评估为10.6%(95%可信区间8.9, 12.3)。在第二次筛查时,该风险降至3.8%(95%可信区间2.7, 4.9),并在随后的轮次中几乎保持不变。在进行10次乳房X光检查后,累积假阳性召回率估计为32.4%(95%可信区间29.7, 35.1)。与假阳性召回累积风险较高相关的因素有:既往良性乳腺疾病(比值比 = 8.48;可信区间7.39, 9.73)、围绝经期状态(比值比 = 1.62;可信区间1.12, 2.34)、体重指数高于27.3(比值比 = 1.17;可信区间1.02, 1.34)以及年龄50 - 54岁(比值比 = 1.15;可信区间1.00, 1.31)。

结论

三分之一的女性在10次两年一次的筛查中可能至少有一次假阳性召回。参与筛查项目的女性应被告知这种风险,尤其是那些有相关因素的女性。

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Reporting of performance indicators of mammography screening in Europe.欧洲乳腺X线筛查性能指标报告。
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