Frikha M, Yaiche O, Elloumi F, Mnejja W, Slimi L, Kassis M, Daoud J
Service d'oncologie médicale, CHU Habib Bourguiba de Sfax, Sfax, Tunisie.
J Gynecol Obstet Biol Reprod (Paris). 2013 May;42(3):252-61. doi: 10.1016/j.jgyn.2013.01.007. Epub 2013 Mar 9.
Evaluation of three rounds of mammography screening pilot programme operated between 2004 and 2010 in Sfax by the founders of Dar El Amal association.
A biennial screening was offered to women aged over 45years and residing in five delegations of Sfax. Two radiologists independently interpret the mammograms.
Twelve thousand six hundred and fifty-seven mammographies were performed. The rate of participation was 17.35%. Women under 50years had the higher rate of participation (34.7%). Some 17.2%/8% (prevalent/incident round) of participants were recalled for further assessment. The chirurgical biopsy rate was 2.1% in prevalence and 1.34% in incidence. The predictive positive value (PPV) of biopsy was 26.5% and 47.14% in the prevalent and incident rounds, respectively. The cancer detection rate amounted to 5.6‰ in prevalent round and to 6.3‰ in incident round. Twenty-five percent of invasive detected cancers were less or equal to 10mm in size and 65.5% were node-negative. The rate of interval cancer was 0.78‰. The performance of screening in this study was undermined by the relative importance of women younger than 50years. The cost of one test was 26,200TD and the cost of one cancer case screening was 6142TD.
This study identified the benefits and limitations of this pilot programme to inform policy makers on the importance and feasibility of an organized mammography screening of breast cancer in Tunisia in a context of a generalization.
评估达尔·阿玛尔协会的创始人于2004年至2010年期间在斯法克斯开展的三轮乳腺钼靶筛查试点项目。
为年龄超过45岁且居住在斯法克斯五个行政区的女性提供两年一次的筛查。两名放射科医生独立解读乳腺钼靶片。
共进行了12657例乳腺钼靶检查。参与率为17.35%。50岁以下女性的参与率更高（34.7%）。约17.2%/8%（普查/初查轮次）的参与者被召回做进一步评估。手术活检率在普查时为2.1%，初查时为1.34%。活检的预测阳性值（PPV）在普查轮次和初查轮次分别为26.5%和47.14%。癌症检出率在普查轮次为5.6‰，初查轮次为6.3‰。检测出的浸润性癌症中，25%的肿瘤大小小于或等于10毫米，65.5%为无淋巴结转移。间期癌发生率为0.78‰。本研究中筛查的效果因50岁以下女性所占的相对比例而受到影响。一次检查的费用为26200第纳尔，筛查一例癌症病例的费用为6142第纳尔。
本研究明确了该试点项目的益处和局限性，以便为政策制定者提供信息，使其了解在突尼斯推广乳腺癌钼靶筛查的重要性和可行性。
