Zakharova N, Duffy Sw, Mackay J, Kotlyarov E
State Clinical Hospital, Khanty-Mansiysk, Khanty-Mansiysky Autonomous Okrug-Ugra, Russian Federation.
Ecancermedicalscience. 2011;5:195. doi: 10.3332/ecancer.2011.195. Epub 2011 Feb 14.
A breast cancer screening programme (BCSP) was started in 21 districts in the Khanty-Mansiysky Autonomous Okrug-Ugra region from 7 February 2007.
From the data on the numbers of subjects screened and the resulting diagnoses we calculated screening coverage rates and cancer detection rates and estimated the sensitivity of the screening tests. The State Cancer Registry was the source for the data regarding the female population by age, the number of breast cancer cases and cancer-related deaths. The data pertained to the period 2002-9, and included pathology data. Disease rates and distribution graphs of tumours by size and node status were analysed using Poisson regression.
The rates of breast cancer incidence and mortality indicate that the region is one in which the population is at medium risk of developing the disease. There was a significant increase in incidence overall during the period studied (p = 0.03), and a significant downward trend in breast-cancer-related mortality to a greater extent in the 50+ age group (p = 0.004), and when all ages 40+ were considered (p < 0.001). During 2007-9 92,576 women were screened in the BCSP. The screening coverage rate was ∼30%. Of the women who were screened, 9% were referred for further assessment. The average cancer detection rate was 2.5 per 1000 women screened. The sensitivity of the test was estimated to be 74%. Approximately 90% of screening-detected cases of breast cancer were at stages 1 or 2 of the disease.
The finding that screening led to tumours being detected at earlier stages of the disease suggests that, in the long term, the programme will be successful in achieving a further reduction in mortality from the disease.
2007年2月7日起，在汉特-曼西自治区-乌格拉地区的21个区启动了一项乳腺癌筛查计划（BCSP）。
根据筛查对象数量及最终诊断数据，我们计算了筛查覆盖率和癌症检出率，并估算了筛查测试的灵敏度。国家癌症登记处是按年龄划分的女性人口、乳腺癌病例数及癌症相关死亡数据的来源。数据涵盖2002 - 2009年期间，包括病理数据。使用泊松回归分析了肿瘤的发病率以及按大小和淋巴结状态划分的肿瘤分布图。
乳腺癌发病率和死亡率表明该地区人群患此病的风险处于中等水平。在研究期间总体发病率显著上升（p = 0.03），与乳腺癌相关的死亡率呈显著下降趋势，在50岁及以上年龄组中下降幅度更大（p = 0.004），在所有40岁及以上年龄组中也有显著下降（p < 0.001）。2007 - 2月9日期间，BCSP对92,576名女性进行了筛查。筛查覆盖率约为30%。在接受筛查的女性中，9%被转诊作进一步评估。平均癌症检出率为每1000名接受筛查的女性中有2.5例。该测试的灵敏度估计为第74%。筛查发现的乳腺癌病例中约90%处于疾病的1期或2期。
筛查导致在疾病早期阶段发现肿瘤这一发现表明，从长远来看，该计划将成功实现该病死亡率的进一步降低。
