Roberts M M, Alexander F E, Anderson T J, Chetty U, Donnan P T, Forrest P, Hepburn W, Huggins A, Kirkpatrick A E, Lamb J
Edinburgh Breast Screening Centre, University of Edinburgh, UK.
Lancet. 1990 Feb 3;335(8684):241-6. doi: 10.1016/0140-6736(90)90066-e.
Between 1979 and 1981, 45,130 women in Edinburgh aged 45-64 were entered into a randomised trial of breast cancer screening by mammography and clinical examination. The initial attendance rate was 61% but this varied according to age and socioeconomic status and decreased over succeeding years. The cancer detection rate was 6.2 per 1000 women attending at the first visit; the rate fell to around 3 per 1000 in the years when mammography was routinely repeated and to around 1 per 1000 at the intervening visits with clinical examination alone as the screening method. After 7 years of follow-up the mortality reduction achieved was 17% (relative risk = 0.83, 95% CI 0.58-1.18), which was not statistically significant, even when corrected for socioeconomic status. In women aged 50 years and over a mortality reduction of 20% was achieved.
1979年至1981年间，爱丁堡45至64岁的45130名女性参与了一项通过乳房X光造影和临床检查进行乳腺癌筛查的随机试验。初始参与率为61%，但因年龄和社会经济地位而异，并在随后几年有所下降。首次就诊时，每1000名女性的癌症检出率为6.2；在常规重复进行乳房X光造影的年份，该比率降至每1000人约3例，而在仅以临床检查作为筛查方法的中间就诊时，该比率降至每1000人约1例。经过7年的随访，死亡率降低了17%（相对风险=0.83，95%置信区间0.58-1.18），即使在对社会经济地位进行校正后，这一结果也无统计学意义。在50岁及以上的女性中，死亡率降低了20%。
