Saunders Carla, Robotin Monica, Crossing Sally
The Cancer Council NSW, Woolloomooloo NSW, Australia.
Aust New Zealand Health Policy. 2008 Nov 6;5:23. doi: 10.1186/1743-8462-5-23.
Breast cancer is the leading cause of cancer death in women in Australia. Early detection provides the best chance of reducing mortality and morbidity from the disease. Mammographic screening is a population health strategy for the early detection of breast cancer in Australia. Recruitment strategies such as regular advertising and biannual screening invitations are exclusively targeted at women aged 50 - 69 years. Even though they can participate, women 70 years or over are not invited or actively encouraged to undertake screening. Research has found that a routine letter of invitation increases the number of women participating in breast cancer screening.
Cancer data analysis and a literature and policy review was conducted to assess age specific breast cancer mortality rates and the legitimacy of rationale used to limit invitations for breast cancer screening to women younger than 70 years.
The proportion of women over 69 years participating in the BreastScreen program is significantly less than rate of screening in the target age range (50-69 years). Evidence and data indicate that common justifications for limiting screening reminders to the target age range including life expectancy, comorbidities, effectiveness, treatment and cost are, for many women, unreasonable.
There is now sufficient data to support a change in the targeted upper age range for breast cancer screening to improve the existing suboptimal surveillance in women aged over 69 years.
乳腺癌是澳大利亚女性癌症死亡的主要原因。早期检测为降低该疾病的死亡率和发病率提供了最佳机会。乳房X光筛查是澳大利亚早期检测乳腺癌的一项群体健康策略。诸如定期广告宣传和每半年发出筛查邀请等招募策略仅针对50至69岁的女性。尽管70岁及以上的女性可以参与，但她们未被邀请或未得到积极鼓励去进行筛查。研究发现，一封常规邀请信会增加参与乳腺癌筛查的女性人数。
进行癌症数据分析以及文献和政策审查，以评估特定年龄的乳腺癌死亡率，以及将乳腺癌筛查邀请限制在70岁以下女性的理由的合理性。
69岁以上女性参与乳房X光筛查项目的比例显著低于目标年龄范围（50 - 69岁）的筛查率。证据和数据表明，将筛查提醒限制在目标年龄范围的常见理由，包括预期寿命、合并症、有效性、治疗和成本等，对许多女性来说是不合理的。
现在有足够的数据支持改变乳腺癌筛查的目标年龄上限，以改善69岁以上女性目前不理想的监测情况。
