奥地利蒂罗尔地区实行十五年机会性乳腺 X 光筛查后的乳腺癌发病率和死亡率。

Breast cancer incidence and mortality in Tyrol/Austria after fifteen years of opportunistic mammography screening.

机构信息

Department of Clinical Epidemiology of the Tyrolean State Hospitals Ltd, Cancer Registry of Tyrol, Innsbruck, Austria.

出版信息

BMC Public Health. 2010 Feb 20;10:86. doi: 10.1186/1471-2458-10-86.

DOI:10.1186/1471-2458-10-86

PMID:20170536

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2843664/

Abstract

BACKGROUND

The aim of this study was to analyse breast cancer incidence and mortality in Tyrol from 1970 to 2006, namely after performing more than a decade of opportunistic mammography screening and just before piloting an organised screening programme. Our investigation was conducted on a population level.

METHODS

To study time trends in breast cancer incidence and mortality, we applied the age-period-cohort model by Poisson regression to the official mortality data covering more than three decades from 1970 to 2006 and to the incidence data ranging from 1988 to 2006. In addition, for incidence data we analysed data on breast cancer staging and compared these with EU guidelines.

RESULTS

For the analysis of time trend in breast cancer mortality in age groups 40-79, an age-period-cohort model fits well and shows for years 2002-2006 a statistically significant reduction of 26% (95% CI 13%-36%) in breast cancer mortality as compared to 1992-1996. We see only slight non-significant increases in breast cancer incidence. For the past five years, incidence data show a 10% proportion of in situ cases, and of 50% for cases in stages II+.

CONCLUSIONS

The opportunistic breast cancer screening programme in Tyrol has only in part exploited the mortality reduction known for organised screening programmes. There seems to be potential for further improvement, and we recommend that an organised screening programme and a detailed screening database be introduced to collect all information needed to analyse the quality indicators suggested by the EU guidelines.

摘要

背景

本研究旨在分析 1970 年至 2006 年蒂罗尔地区的乳腺癌发病率和死亡率，这段时期经历了十多年的机会性乳房 X 线筛查，并且在试行有组织的筛查计划之前。我们的研究是在人群水平上进行的。

方法

为了研究乳腺癌发病率和死亡率的时间趋势，我们应用泊松回归的年龄-时期-队列模型，对官方死亡率数据进行了分析，这些数据涵盖了 1970 年至 2006 年的三十多年，以及 1988 年至 2006 年的发病率数据。此外，我们还对乳腺癌分期的发病率数据进行了分析，并将其与欧盟指南进行了比较。

结果

在 40-79 岁年龄组中，对乳腺癌死亡率的时间趋势进行分析，年龄-时期-队列模型拟合良好，显示 2002-2006 年与 1992-1996 年相比，乳腺癌死亡率统计学上显著降低了 26%（95%CI 13%-36%）。我们只观察到乳腺癌发病率略有、无统计学意义的增加。过去五年，发病率数据显示原位病例的比例为 10%，II+期病例的比例为 50%。