40-49 岁女性有效的每两年一次的乳房 X 光筛查。

Effective biennial mammographic screening in women aged 40-49.

机构信息

Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.

出版信息

Eur J Cancer. 2010 Dec;46(18):3137-40. doi: 10.1016/j.ejca.2010.09.041. Epub 2010 Oct 28.

DOI:10.1016/j.ejca.2010.09.041

PMID:21036034

Abstract

BACKGROUND

The United Kingdom is currently moving the age limit for invitation in its national breast screening programme downwards from 50 to 47. In contrast, the US Preventive Services Task Force concluded that, because of borderline statistical significance on effectiveness of mammographic screening, the current evidence is insufficient to advise screening in women aged 40-49.

MATERIAL AND METHODS

We designed a case-referent study to investigate the effect of biennial mammographic screening on breast cancer mortality for women in their forties. In Nijmegen, the Netherlands, screening started in 1975. A total of 272 breast cancer deaths were identified, and 1360 referents aged 40-69 were sampled from the population invited for screening. Effectiveness was estimated by calculating the odds ratio (OR) indicating the breast cancer death rate in screened versus unscreened women.

RESULTS

In women aged 40-49, the effect of screening was OR = 0.50 (95% confidence interval (CI) = 0.30-0.82). This result is similar to those aged 50-59 (OR = 0.54; 95% CI = 0.35-0.85) and 60-69 (OR = 0.65; 95% CI = 0.38-1.13).

CONCLUSION

Our results add convincing evidence about the effectiveness of biennial mammographic screening in women aged 40-49.

摘要

背景

英国目前正在将其国家乳房筛查计划的邀请年龄下限从 50 岁降低到 47 岁。相比之下，美国预防服务工作组的结论是，由于在乳腺筛查的有效性方面存在边缘统计学意义，目前的证据不足以建议对 40-49 岁的女性进行筛查。

材料与方法

我们设计了一项病例对照研究，以调查 40 多岁女性每两年进行一次乳房 X 光筛查对降低乳腺癌死亡率的效果。在荷兰奈梅亨，筛查始于 1975 年。共确定了 272 例乳腺癌死亡病例，并从受邀接受筛查的人群中抽取了 1360 名年龄在 40-69 岁的对照者。通过计算指示筛查与未筛查女性乳腺癌死亡率的比值比（OR）来估计有效性。