Hauge Ingrid Helen Ryste, Pedersen Kristin, Olerud Hilde Merete, Hole Eli Olaug, Hofvind Solveig
Norwegian Radiation Protection Authority, Østerås, Norway Department of Physics, University of Oslo, Oslo, Norway Oslo and Akershus University College of Applied Sciences, Faculty of Health Sciences, Department of Radiography and Dental Technology, Oslo, Norway
Norwegian Radiation Protection Authority, Østerås, Norway.
Acta Radiol. 2014 Dec;55(10):1174-9. doi: 10.1177/0284185113514051. Epub 2013 Dec 5.
The main aim of mammographic screening is to reduce the mortality from breast cancer. However, use of ionizing radiation is considered a potential harm due to the possible risk of inducing cancer in healthy women.
To estimate the potential number of radiation-induced breast cancers, radiation-induced breast cancer deaths, and lives saved due to implementation of organized mammographic screening as performed in Norway.
We used a previously published excess absolute risk model which assumes a linear no-threshold dose-response. The estimates were calculated for 100,000 women aged 50-69 years, a screening interval of 2 years, and with an assumed follow-up until the age of 85 or 105 years. Radiation doses of 0.7, 2.5, and 5.7 mGy per screening examination, a latency time of 5 or 10 years, and a dose and dose-rate effectiveness factor (DDREF) of 1 or 2 were applied.
The total lifetime risk of radiation-induced breast cancers per 100,000 women was 10 (95% CI: 4-25) if the women were followed from the ages of 50 to 85 years, for a dose of 2.5 mGy, a latency time of 10 years, and a DDREF of 1. For the same parameter values the number of radiation-induced breast cancer death was 1 (95% CI: 0-2). The assumed number of lives saved is approximately 350.
The risk of radiation-induced breast cancer and breast cancer death due to mammographic screening is minimal. Women should not be discouraged from attending screening due to fear of radiation-induced breast cancer death.
乳腺钼靶筛查的主要目的是降低乳腺癌死亡率。然而,由于电离辐射可能对健康女性诱发癌症,因此其使用被认为存在潜在危害。
估计因挪威实施的有组织乳腺钼靶筛查可能导致的辐射诱发乳腺癌病例数、辐射诱发乳腺癌死亡数以及挽救的生命数。
我们使用了先前发表的超额绝对风险模型,该模型假定剂量反应呈线性无阈值关系。针对100,000名年龄在50 - 69岁的女性进行了估计,筛查间隔为2年,并假定随访至85岁或105岁。每次筛查的辐射剂量分别为0.7、2.5和5.7毫戈瑞,潜伏期为5年或10年,剂量与剂量率效能因子(DDREF)为1或2。
如果女性从50岁随访至85岁,对于2.5毫戈瑞的剂量、10年的潜伏期以及1的DDREF,每100,000名女性辐射诱发乳腺癌的终生风险为10例(95%置信区间:4 - 25)。对于相同参数值,辐射诱发乳腺癌死亡数为1例(95%置信区间:0 - 2)。假定挽救的生命数约为350例。
乳腺钼靶筛查导致的辐射诱发乳腺癌及乳腺癌死亡风险极小。不应因担心辐射诱发乳腺癌死亡而使女性放弃筛查。