Weill Cornell Imaging at New York-Presbyterian, New York, New York.
Department of Radiology, University of Colorado-Denver, School of Medicine, Denver, Colorado.
Cancer. 2017 Oct 1;123(19):3673-3680. doi: 10.1002/cncr.30842. Epub 2017 Aug 21.
Currently, there are several different recommendations for screening mammography from major national health care organizations, including: 1) annual screening at ages 40 to 84 years; 2) screening annually at ages 45 to 54 years, then biennially at ages 55 to 79 years; and 3) biennial screening at ages 50 to 74 years.
Mean values of six Cancer Intervention and Surveillance Modeling Network (CISNET) models were used to compare these three screening mammography recommendations in terms of benefits and risks.
Mean mortality reduction was greatest with the recommendation of annual screening at ages 40 to 84 years (39.6%), compared with the hybrid recommendation of screening annually at ages 45 to 54 years, then biennially at ages 55 to 79 years (30.8%), and the recommendation of biennial screening at ages 50 to 74 years (23.2%). For a single-year cohort of US women aged 40 years, assuming 100% compliance, more breast cancers deaths would be averted over their lifetime with annual screening starting at age 40 (29,369) than with the hybrid recommendation (22,829) or biennial screening ages 50-74 (17,153 based on 2009 CISNET estimates, 15,599 based on 2016 CISNET estimates). To achieve the greatest mortality benefit, this single-year cohort of women would have the greatest total number of screening mammograms, benign recalls, and benign biopsies performed over the course of screening by following annual screening starting at age 40 years (90.2 million, 6.8 million, and 481,269, respectively) than by following the hybrid recommendation (49.0 million, 4.1 million, and 286,288, respectively) or biennial screening at ages 50 to 74 years (27.3 million, 2.3 million, and 162,885, respectively).
CISNET models demonstrate that the greatest mortality reduction is achieved with annual screening of women starting at age 40 years. Cancer 2017;123:3673-3680. © 2017 American Cancer Society.
目前，多个主要的国家卫生保健组织提出了不同的筛查乳房 X 线照片的建议，包括：1）40 岁至 84 岁期间每年筛查；2）45 岁至 54 岁期间每年筛查，然后 55 岁至 79 岁期间每两年筛查一次；3）50 岁至 74 岁期间每两年筛查一次。
采用癌症干预和监测建模网络（CISNET）的 6 个模型的平均值，根据获益和风险比较这 3 种筛查乳房 X 线照片的建议。
与 45 岁至 54 岁开始每年筛查，然后 55 岁至 79 岁期间每两年筛查一次的混合建议（30.8%）以及 50 岁至 74 岁期间每两年筛查一次的建议（23.2%）相比，40 岁至 84 岁期间每年筛查可使死亡率降低幅度最大（39.6%）。对于一个年龄为 40 岁的美国女性的单一年龄队列，如果 100%遵循建议，终生避免的乳腺癌死亡人数将随着 40 岁开始每年筛查（29369 例）而高于混合建议（22829 例）或 50-74 岁期间每两年筛查（基于 2009 年 CISNET 估计值为 17153 例，基于 2016 年 CISNET 估计值为 15599 例）。为了获得最大的生存获益，该单一年龄队列的女性将进行最多数量的筛查乳房 X 线照片检查、良性召回和良性活检，遵循 40 岁开始每年筛查（分别为 9020 万次、680 万次和 481269 次）高于遵循混合建议（分别为 4900 万次、410 万次和 286288 次）或 50 岁至 74 岁期间每两年筛查（分别为 2730 万次、230 万次和 162885 次）。
CISNET 模型表明，从 40 岁开始对女性进行每年筛查可获得最大的死亡率降低。癌症 2017；123：3673-3680。©2017 美国癌症协会。
