Lynge Elsebeth, Beau Anna-Belle, Christiansen Peer, von Euler-Chelpin My, Kroman Niels, Njor Sisse, Vejborg Ilse
Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK 1014 København K, Denmark.
Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK 1014 København K, Denmark.
Eur J Cancer. 2017 Jul;80:26-29. doi: 10.1016/j.ejca.2017.04.018. Epub 2017 May 20.
Overdiagnosis in breast cancer screening is an important issue. A recent study from Denmark concluded that one in three breast cancers diagnosed in screening areas in women aged 50-69 years were overdiagnosed. The purpose of this short communication was to disentangle the study's methodology in order to evaluate the soundness of this conclusion. We found that both the use of absolute differences as opposed to ratios; the sole focus on non-advanced tumours and the crude allocation of tumours and person-years by screening history for women aged 70-84 years, all contributed to the very high estimate of overdiagnosis. Screening affects cohorts of screened women. Danish registers allow very accurate mapping of the fate of every woman. We should be past the phase where studies of overdiagnosis are based on the fixed age groups from routine statistics.
乳腺癌筛查中的过度诊断是一个重要问题。丹麦最近的一项研究得出结论，在50 - 69岁女性的筛查区域诊断出的乳腺癌中，三分之一是过度诊断。这篇简短通讯的目的是剖析该研究的方法，以评估这一结论的可靠性。我们发现，使用绝对差异而非比率；仅关注非晚期肿瘤；以及对70 - 84岁女性按筛查史对肿瘤和人年进行粗略分配，所有这些都导致了对过度诊断的极高估计。筛查会影响接受筛查的女性队列。丹麦的登记系统能非常准确地追踪每位女性的情况。我们应该超越基于常规统计中固定年龄组进行过度诊断研究的阶段。
