Cardiff School of Mathematics, Cardiff University, Cardiff, Wales, UK.
Health Care Manag Sci. 2011 Jun;14(2):203-11. doi: 10.1007/s10729-011-9156-9. Epub 2011 Mar 29.
Screening for early detection of breast cancer is considered to be an important element of preventive medicine. In this paper, we use numerical simulations to examine the length bias in regular interval screening programmes, by computing the doubling times of breast cancer tumours detected through regular mammographies compared to self-detection. Our analysis shows that doubling times of tumours detected by a regular screening programme are longer than doubling times in the original whole population and considerably longer than those self-detected. Hence regular interval mammographies may be missing a high proportion of fast growing tumours and therefore the benefits of current screening programmes may need to be re-evaluated. We examine the likely size of the length bias for the present UK breast cancer screening programme and perform a sensitivity analysis by varying the screen detection probabilities to reflect future advances in mammographic detection.
筛查早期乳腺癌被认为是预防医学的重要组成部分。在本文中，我们通过数值模拟来研究定期间隔筛查计划中的长度偏差，通过计算定期乳房 X 光检查检测到的乳腺癌肿瘤与自我检测相比的倍增时间。我们的分析表明，定期筛查计划检测到的肿瘤倍增时间长于原始总体人群中的倍增时间，并且比自我检测到的倍增时间长得多。因此，定期间隔乳房 X 光检查可能会错过很大一部分快速生长的肿瘤，因此需要重新评估当前筛查计划的益处。我们检查了目前英国乳腺癌筛查计划中长度偏差的可能大小，并通过改变屏幕检测概率来进行敏感性分析，以反映乳房 X 光检测的未来进展。
