Bouchlaka A, Ben Abdallah M, Ben Aissa R, Zaanouni E, Kribi L, Smida S, M'barek F, Ben Hamida A, Boussen H, Gueddana N
Division Recherche Biomédicale, Office National de la Famille et de la Population, Tunis, Tunisie.
Tunis Med. 2009 Jul;87(7):438-42.
To asses and analyse the results of 3 years large scale mammography screening of breast cancer in Ariana state in Tunisia.
This program, managed by the Family and Population National Office, was addressing to women aged from 49 to 69 years old residing in a area with adds up a population of 459 700 inhabitants including 52,729 women in the target age population. The screening was including a breast clinical examination and a mammography with two incidences face and external profile. The women was invited at their residence or were sensitized in the reproductive health centers, care and base health centers or by a close relation which heard of the program. An enlightened assent was submitted to the women who wished to profit from the screening.
In three years, 9093 mammography were carried out of which 8244 were retained in the analyses, that is to say a rate participation of 9.6%. The rate of women recalled for suspect test was of 18.1% and it was of 13.1% among women of more than 50 years. The rate of practiced surgical biopsies was of 0.5% and the positive predictive value was of 45.5%. The average time between the date of screening and the result of the screening was 9.7 days, more important in the event of tests requiring a complementary assessment (61.7 days). On the whole 40 cancers were detected by the program, that is to say a rough rate of detected cancers, of 4.9 per thousand, in conformity with the recommendations. The percentage of invasive cancers < or = 10 mm was of 24.3 whereas percentages of in situ cancers and of cancers without ganglionic invasion were respectively of 7.7% and of 50.0%.
The weakness of our study lay primarily in the rate of participation which remained weak. The methodology adopted for the sensitizing of the women is proven not very effective and did not allow inviting all eligible women. Results of the study are encouraging in spite of its limited impact and made it possible to detect an important rate of cancers of which cancers infra-private clinics.
评估和分析突尼斯阿里亚纳省为期3年的大规模乳腺癌钼靶筛查结果。
该项目由国家家庭与人口办公室管理，面向居住在某地区、年龄在49至69岁之间的女性，该地区总人口为459700人，其中目标年龄人群中的女性有52729人。筛查包括乳房临床检查和钼靶检查，钼靶检查有两个投照位，即正位和侧斜位。女性被邀请到其住所，或在生殖健康中心、医疗保健和基层医疗中心接受宣传，或由听说该项目的近亲进行宣传。对于希望接受筛查的女性，提交了知情同意书。
3年内共进行了9093例钼靶检查，其中8244例纳入分析，即参与率为9.6%。被召回进行疑似检查的女性比例为18.1%，50岁以上女性中这一比例为13.1%。实施手术活检的比例为0.5%，阳性预测值为45.5%。筛查日期与筛查结果之间的平均时间为9.7天，对于需要补充评估的检查，这一平均时间更长（61.7天）。该项目共检测出40例癌症，即粗略的癌症检出率为千分之4.9，符合相关建议。浸润性癌≤10毫米的比例为24.3%，原位癌和无淋巴结转移癌的比例分别为7.7%和50.0%。
我们研究的不足之处主要在于参与率仍然较低。事实证明，用于女性宣传的方法效果不佳，无法邀请到所有符合条件的女性。尽管该研究的影响有限，但研究结果令人鼓舞，并且能够检测出相当比例的癌症，包括基层医疗诊所漏诊的癌症。
