美国不同阶段乳腺癌发病率变化与筛查指南变更的关系
Breast Cancer Incidence by Stage Before and After Change in Screening Guidelines.
机构信息
Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas; Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, Texas.
Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, Texas; Office of Biostatistics, Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas; Institute for Translational Science, University of Texas Medical Branch, Galveston, Texas.
出版信息
Am J Prev Med. 2019 Jan;56(1):100-108. doi: 10.1016/j.amepre.2018.08.018.
INTRODUCTION
The U.S. Preventive Services Task Force changed breast cancer screening guidelines in November 2009 for mammograms in women aged 40-49 and 50-74 years. The aim of this study was to assess the impact of the 2009 guideline changes on breast cancer incidence by stage among women aged 40-49 and 50-74 years in the U.S.
METHODS
This was a cross-sectional trend analysis of the impact of 2009 guideline change on breast cancer incidence by stage, using data from the National Program for Cancer Registries and Surveillance, Epidemiology, and End Results Incidence-U.S. Cancer Statistics 2001-2014 database among women aged 40-74 years. Incidence was age adjusted to the U.S. standard population. Data were collected in 2001-2014, released in 2017, and analyzed in 2018.
RESULTS
Among women aged 40-49 years, the 4-year average annual incidence of breast cancer increased slightly in 2011-2014 for in situ, localized, and distant cancer, but decreased for regional cancer compared with the incidence in 2006-2009. Among women aged 50-74 years, the 4-year average annual incidence of breast cancer increased in 2011-2014 for localized and distant cancer, but decreased for in situ and regional cancer. Joinpoint analyses revealed that annual percentage changes decreased after 2009 for distant cancer among both women aged 40-49 and 50-74 years. The composition of breast cancer by stage was similar between 2006-2009 and 2011-2014 among both women aged 40-49 and 50-74 years.
CONCLUSIONS
Changes in breast cancer screening by the 2009 U.S. Preventive Services Task Force guidelines had little immediate adverse effects on the stage distribution of breast cancer diagnoses in the U.S. Monitoring the incidence by cancer stages over time is needed.
简介
美国预防服务工作组于 2009 年 11 月改变了 40-49 岁和 50-74 岁女性的乳腺癌筛查指南。本研究的目的是评估 2009 年指南变化对美国 40-49 岁和 50-74 岁女性乳腺癌分期发病率的影响。
方法
这是一项使用国家癌症登记和监测、流行病学和结果-美国癌症统计数据 2001-2014 数据库中 40-74 岁女性的 2009 年指南变化对乳腺癌分期发病率影响的横断面趋势分析。发病率按美国标准人口进行年龄调整。数据于 2001-2014 年收集，于 2017 年发布，并于 2018 年进行分析。
结果
在 40-49 岁的女性中，2011-2014 年原位癌、局限性癌和远处癌的 4 年平均年发病率略有上升，但与 2006-2009 年相比，区域性癌症的发病率有所下降。在 50-74 岁的女性中，2011-2014 年局限性癌和远处癌的 4 年平均年发病率有所上升，但原位癌和区域性癌的发病率有所下降。Joinpoint 分析显示，2009 年后，40-49 岁和 50-74 岁女性的远处癌年百分比变化均有所下降。在 40-49 岁和 50-74 岁的女性中，2006-2009 年和 2011-2014 年之间的乳腺癌分期构成相似。
结论
2009 年美国预防服务工作组指南对美国乳腺癌诊断的分期分布没有立即产生不利影响。需要随着时间的推移监测癌症分期的发病率。
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