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瑞典乳腺癌钼靶筛查两县试验:近期结果及获益计算

The Swedish two county trial of mammographic screening for breast cancer: recent results and calculation of benefit.

作者信息

Tabar L, Fagerberg G, Duffy S W, Day N E

机构信息

Department of Mammography, Central Hospital, Falun, Sweden.

出版信息

J Epidemiol Community Health. 1989 Jun;43(2):107-14. doi: 10.1136/jech.43.2.107.

Abstract

The Swedish two county trial of breast cancer screening is now in its tenth year. This paper presents detailed results on mortality from breast cancer and from all other causes, and on the population denominators at risk for each of the first 8 years of follow up, for each county separately. These data represent a two year update on the last major report. Results show an increasingly significant deficit in deaths from breast cancer among the 77,092 women invited to screening relative to the 56,000 not invited (RR = 0.68, p = 0.002), with no significant difference between the effects of screening in the two counties (p = 0.5). These results remain the same when adjusted for age. Analysis of all cause deaths shows no significant effect of screening (p = 0.5), nor was there any significant effect of screening on deaths from all causes other than breast cancer (p = 0.9). The rates of deaths from intercurrent illness in breast cancer cases were almost identical in the group invited to screening and the group not invited (p = 0.7). This result remained the same when adjusted for age. We calculate that in the age group 50-69 at entry, one breast cancer death was prevented per 4000 woman/years, per 1460 mammographic examinations, per 13.5 biopsies, and per 7.4 breast cancers detected.

摘要

瑞典两县乳腺癌筛查试验现已进入第十个年头。本文分别给出了两个县在前8年随访期间,乳腺癌死亡率、其他所有原因导致的死亡率以及各年的危险人群分母的详细结果。这些数据是对上一份主要报告的两年期更新。结果显示,在受邀参加筛查的77,092名女性中,乳腺癌死亡人数相对于未受邀的56,000名女性显著减少(RR = 0.68,p = 0.002),两个县的筛查效果无显著差异(p = 0.5)。调整年龄后,这些结果保持不变。全因死亡分析显示筛查无显著效果(p = 0.5),筛查对除乳腺癌以外的所有原因导致的死亡也无显著影响(p = 0.9)。受邀参加筛查组和未受邀组乳腺癌患者并发疾病的死亡率几乎相同(p = 0.7)。调整年龄后,这一结果保持不变。我们计算得出,在入组时年龄为50 - 69岁的人群中,每4000名女性/年、每1460次乳房X光检查、每13.5次活检以及每检测出7.4例乳腺癌可预防1例乳腺癌死亡。

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本文引用的文献

2
Screening for breast cancer: the Swedish trial.
Radiology. 1981 Jan;138(1):219-22. doi: 10.1148/radiology.138.1.7005939.
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Screening for breast cancer: workshop report.
Eur J Cancer Clin Oncol. 1988 Jan;24(1):55-9. doi: 10.1016/0277-5379(88)90176-9.

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