van Oortmarssen G J, Habbema J D, Lubbe J T, van der Maas P J
Department of Public Health and Social Medicine, Medical Faculty, Erasmus University Rotterdam, The Netherlands.
Int J Cancer. 1990 Aug 15;46(2):207-13. doi: 10.1002/ijc.2910460211.
A computer simulation approach is used to test assumptions about sensitivity of mammography and physical examination, and about the duration of preclinical screen-detectable breast cancer. Values between 50% and 80% for the combined sensitivity of the 2 tests give a good explanation of the results of the HIP randomized trial of breast cancer screening. The mean duration of the preclinical stage can vary from 1.6 years for high sensitivity values to 2.7 years for low values. In comparison with previous analyses of the HIP data our estimate for the sensitivity is lower, and the mean duration of the preclinical stage is longer. This is a consequence of the use of a more detailed model in our analysis, allowing for a more complete use of the HIP data in testing model assumptions. Similar analyses of data from recent screening projects in The Netherlands resulted in compatible estimates for the duration of preclinical breast cancer.
采用计算机模拟方法来检验关于乳房X线摄影和体格检查的敏感性以及临床前可筛查出的乳腺癌持续时间的假设。两种检查联合敏感性在50%至80%之间的值能够很好地解释乳腺癌筛查HIP随机试验的结果。临床前阶段的平均持续时间可能从高敏感性值时的1.6年到低敏感性值时的2.7年不等。与之前对HIP数据的分析相比，我们对敏感性的估计更低，临床前阶段的平均持续时间更长。这是我们在分析中使用了更详细模型的结果，使得在检验模型假设时能够更充分地利用HIP数据。对荷兰近期筛查项目数据的类似分析得出了与临床前乳腺癌持续时间相符的估计。
