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发展中国家的乳腺癌筛查

Breast cancer screening in developing countries.

作者信息

da Costa Vieira René Aloísio, Biller Gabriele, Uemura Gilberto, Ruiz Carlos Alberto, Curado Maria Paula

机构信息

Programa de Pós-Graduação em Oncologia, Hospital de Câncer de Barretos, Barretos, SP, BR.

Programa de Pós-graduação em Obstetricia, Ginecologia e Mastologia, Faculdade de Medicina de Botucatu - UNESP, Botucatu, SP, BR.

出版信息

Clinics (Sao Paulo). 2017 Apr;72(4):244-253. doi: 10.6061/clinics/2017(04)09.

Abstract

Developing countries have limited healthcare resources and use different strategies to diagnose breast cancer. Most of the population depends on the public healthcare system, which affects the diagnosis of the tumor. Thus, the indicators observed in developed countries cannot be directly compared with those observed in developing countries because the healthcare infrastructures in developing countries are deficient. The aim of this study was to evaluate breast cancer screening strategies and indicators in developing countries. A systematic review and the Population, Intervention, Comparison, Outcomes, Timing, and Setting methodology were performed to identify possible indicators of presentation at diagnosis and the methodologies used in developing countries. We searched PubMed for the terms "Breast Cancer" or "Breast Cancer Screening" and "Developing Country" or "Developing Countries". In all, 1,149 articles were identified. Of these articles, 45 full articles were selected, which allowed us to identify indicators related to epidemiology, diagnostic intervention (diagnostic strategy, diagnostic infrastructure, percentage of women undergoing mammography), quality of intervention (presentation of symptoms at diagnosis, time to diagnosis, early stage disease), comparisons (trend curves, subpopulations at risk) and survival among different countries. The identification of these indicators will improve the reporting of methodologies used in developing countries and will allow us to evaluate improvements in public health related to breast cancer.

摘要

发展中国家的医疗资源有限,且采用不同策略来诊断乳腺癌。大部分人口依赖公共医疗体系,这对肿瘤的诊断产生影响。因此,发达国家所观察到的指标不能直接与发展中国家的指标相比较,因为发展中国家的医疗基础设施存在缺陷。本研究的目的是评估发展中国家的乳腺癌筛查策略和指标。我们进行了一项系统综述,并采用人群、干预措施、对照、结局、时间和研究背景方法来确定诊断时的可能表现指标以及发展中国家所使用的方法。我们在PubMed上搜索了“乳腺癌”或“乳腺癌筛查”以及“发展中国家”等关键词。总共识别出1149篇文章。在这些文章中,挑选出45篇全文,这使我们能够识别与流行病学、诊断干预(诊断策略、诊断基础设施、接受乳房X线摄影检查的女性比例)、干预质量(诊断时的症状表现、诊断时间、疾病早期阶段)、对照(趋势曲线、高危亚人群)以及不同国家生存率相关的指标。这些指标的确定将改善对发展中国家所使用方法的报告,并使我们能够评估与乳腺癌相关的公共卫生改善情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67f6/5401614/cbc1ef0bc964/cln-72-04-244-g001.jpg

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