Gustafsson L, Adami H O
Department of Technology, Uppsala University, Sweden.
Br J Cancer. 1990 Jun;61(6):903-8. doi: 10.1038/bjc.1990.202.
Parameters characterising the progression of cervical neoplasia were estimated from population-based cancer and mortality statistics in Sweden for 1958-1981 by means of a dynamic computer model. Proceeding from that model and these data, the incidence and prevalence curves were constructed, the effects of the extensive cytological screening measures introduced during the 1960s were assessed, and future gains due to the measures already undertaken up to 1981 could be simulated. About 4,000 cases of cancer in situ were diagnosed annually in Sweden after the end of the 1960s, most of them in women born later than 1919. The maximum reduction in the number of invasive cancers up to 1981 was 42% for women born in 1919-1923, but increased progressively for later birth cohorts and reached 69% for those born in 1934-1938. The corresponding reduction in mortality rates was of the same magnitude. The screening measures up to 1981 will ultimately result in a reduction of invasive cancer by about 12,500 cases and of the number of deaths due to this disease by about 4,100. Only a part of the total gain in the number of lives saved had been revealed at the end of the study period in 1981.
通过一个动态计算机模型，根据瑞典1958 - 1981年基于人群的癌症和死亡率统计数据，估算了表征宫颈肿瘤进展的参数。基于该模型和这些数据，构建了发病率和患病率曲线，评估了20世纪60年代实施的广泛细胞学筛查措施的效果，并模拟了截至1981年已采取措施未来可能带来的收益。20世纪60年代末后，瑞典每年约诊断出4000例原位癌病例，其中大多数发生在1919年以后出生的女性中。截至1981年，1919 - 1923年出生的女性浸润性癌数量最多减少了42%，但对于较晚出生队列这一数字逐渐增加，1934 - 1938年出生的女性达到了69%。死亡率的相应降低幅度相同。截至1981年的筛查措施最终将使浸润性癌减少约12500例，因该疾病导致的死亡人数减少约4100例。在1981年研究期结束时，挽救生命总数的全部收益中只有一部分显现出来。
