Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado.
Department of Radiology, Duke University Medical Center, Durham, North Carolina.
Cancer. 2019 May 1;125(9):1482-1488. doi: 10.1002/cncr.31954. Epub 2019 Feb 11.
From 1975 to 1990, female breast cancer mortality rates in the United States increased by 0.4% per year. Since 1990, breast cancer mortality rates have fallen between 1.8% and 3.4% per year, a decrease that is attributed to increased mammography screening and improved treatment.
The authors used age-adjusted female breast cancer mortality rate and population data from the Surveillance, Epidemiology, and End Results (SEER) program to estimate the number of breast cancer deaths averted by screening mammography and improved treatment since 1989. Four different assumptions regarding background mortality rates (in the absence of screening mammography and improved treatment) were used to estimate deaths averted for women aged 40 to 84 years by taking the difference between SEER-reported mortality rates and background mortality rates for each 5-year age group, multiplied by the population for each 5-year age group. SEER data were used to estimate annual and cumulative breast cancer deaths averted in 2012 and 2015 and extrapolated SEER data were used to estimate deaths averted in 2018.
The number of single-year breast cancer deaths averted ranged from 20,860 to 33,842 in 2012, from 23,703 to 39,415 in 2015, and from 27,083 to 45,726 in 2018. Breast cancer mortality reductions ranged from 38.6% to 50.5% in 2012, from 41.5% to 54.2% in 2015, and from 45.3% to 58.3% in 2018. Cumulative breast cancer deaths averted since 1989 ranged from 237,234 to 370,402 in 2012, from 305,934 to 483,435 in 2015, and from 384,046 to 614,484 in 2018.
Since 1989, between 384,000 and 614,500 breast cancer deaths have been averted through the use of mammography screening and improved treatment.
1975 年至 1990 年期间,美国女性乳腺癌死亡率每年增长 0.4%。自 1990 年以来,乳腺癌死亡率每年下降 1.8%至 3.4%,这归因于乳腺 X 线筛查的增加和治疗的改善。
作者使用监测、流行病学和最终结果(SEER)计划的年龄调整女性乳腺癌死亡率和人口数据,估算自 1989 年以来,通过筛查乳腺 X 线摄影和改善治疗避免的乳腺癌死亡人数。使用了四种关于背景死亡率(在没有筛查乳腺 X 线摄影和改善治疗的情况下)的假设,以通过取每个 5 岁年龄组的 SEER 报告死亡率和背景死亡率之间的差异,乘以每个 5 岁年龄组的人口,来估算 40 至 84 岁女性避免的死亡人数。使用 SEER 数据估算 2012 年和 2015 年避免的年度和累计乳腺癌死亡人数,并外推 SEER 数据以估算 2018 年避免的死亡人数。
2012 年避免的单年乳腺癌死亡人数范围为 20860 至 33842 人,2015 年为 23703 至 39415 人,2018 年为 27083 至 45726 人。乳腺癌死亡率降低幅度在 2012 年为 38.6%至 50.5%,在 2015 年为 41.5%至 54.2%,在 2018 年为 45.3%至 58.3%。自 1989 年以来,2012 年避免的累计乳腺癌死亡人数范围为 237234 至 370402 人,2015 年为 305934 至 483435 人,2018 年为 384046 至 614484 人。
自 1989 年以来,通过乳腺 X 线筛查和治疗的改善,避免了 384000 至 614500 例乳腺癌死亡。