Day N E, Williams D R, Khaw K T
MRC Biostatistics, Cambridge, UK.
Br J Cancer. 1989 Jun;59(6):954-8. doi: 10.1038/bjc.1989.203.
It is important that the introduction of breast screening is closely monitored. The anticipated effect on breast cancer mortality will take 10 years or more fully to emerge, and will only occur if a succession of more short-term end points are met. Data from the Swedish two-county randomised trial provide targets that should be achieved, following a logical progression of compliance with the initial invitation, prevalence and stage distribution at the prevalence screen, the rate of interval cancers after the initial screen, the pick-up rate and stage distribution at later screening tests, the rate of interval cancers after later tests, the absolute rate of advanced cancer and finally the breast cancer mortality rate. For evaluation purposes, historical data on stage at diagnosis is desirable; it is suggested that tumour size is probably the most relevant variable available in most cases.
密切监测乳腺癌筛查的引入情况非常重要。对乳腺癌死亡率的预期影响将需要10年或更长时间才能完全显现，而且只有在一系列更短期的终点指标都得到满足时才会出现。瑞典两县随机试验的数据提供了应实现的目标，这些目标遵循以下逻辑顺序：对初次邀请的依从性、普查时的患病率和分期分布、初次筛查后的间期癌发生率、后续筛查试验中的检出率和分期分布、后续试验后的间期癌发生率、晚期癌症的绝对发生率，最后是乳腺癌死亡率。出于评估目的，诊断时分期的历史数据是可取的；建议在大多数情况下肿瘤大小可能是最相关的可用变量。
