Gabe R, Tryggvadóttir L, Sigfússon B F, Olafsdóttir G H, Sigurdsson K, Duffy S W
Cancer Research UK, Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, London, UK and Icelandic Cancer Society (Krabbameinsfélag Islands), Reykjavik, Iceland.
Acta Radiol. 2007 Nov;48(9):948-55. doi: 10.1080/02841850701501725.
The Icelandic breast cancer screening program, initiated November 1987 in Reykjavik and covering the whole country from December 1989, comprises biennial invitation to mammography for women aged 40-69 years old.
To estimate the impact of mammography service screening in Iceland on deaths from breast cancer.
Cases were deaths from breast cancer from 1990 onwards in women aged 40 and over at diagnosis, during the period November 1987 to December 31, 2002. Age- and screening-area-matched, population-based controls were women who had also been invited to screening but were alive at the time their case died.
Using conditional logistic regression on the data from 226 cases and 902 controls, the odds ratio for the risk of death from breast cancer in those attending at least one screen compared to those never screened was 0.59 (95% CI 0.41-0.84). After adjustment for healthy-volunteer bias and screening-opportunity bias, the odds ratio was 0.65 (95% CI 0.39-1.09).
These results indicate a 35-40% reduction in breast cancer deaths by attending the Icelandic breast cancer screening program. These results are consistent with the overall evidence from other observational evaluations of mammography-based programs.
冰岛乳腺癌筛查项目于1987年11月在雷克雅未克启动，1989年12月覆盖全国，包括每两年邀请40 - 69岁女性进行乳房X光检查。
评估冰岛乳房X光检查服务筛查对乳腺癌死亡的影响。
病例为1990年起诊断时年龄在40岁及以上的乳腺癌死亡女性，时间段为1987年11月至2002年12月31日。年龄和筛查区域匹配的基于人群的对照是那些也被邀请参加筛查但在其病例死亡时仍存活的女性。
对226例病例和902例对照的数据进行条件逻辑回归分析，与从未接受筛查的女性相比，至少接受过一次筛查的女性死于乳腺癌的风险优势比为0.59（95%可信区间0.41 - 0.84）。在调整健康志愿者偏倚和筛查机会偏倚后，优势比为0.65（95%可信区间0.39 - 1.09）。
这些结果表明，参加冰岛乳腺癌筛查项目可使乳腺癌死亡人数减少35% - 40%。这些结果与其他基于乳房X光检查项目的观察性评估的总体证据一致。
