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乳腺癌筛查:使用移动乳腺摄影设备改善可及性的模型[乳腺癌监测:使用移动乳腺摄影设备改善可及性的模型]

[Breast cancer screening: modeling improvement of access using mobile mammography unitsSeguimiento del cáncer de mama: modelo de mejora del acceso con el uso de mamógrafos móviles].

作者信息

da Cunha Gerson Nunes, Vianna Cid Manso de Mello, Mosegui Gabriela Bittencourt Gonzalez, da Silva Marcus Paulo Rodrigues, Jardim Fernando Nagib

机构信息

Faculdade de Tecnologia do Estado do Rio de Janeiro Faculdade de Tecnologia do Estado do Rio de Janeiro PetrópolisRJ Brasil Faculdade de Tecnologia do Estado do Rio de Janeiro, Petrópolis (RJ), Brasil.

Instituto de Medicina Social Instituto de Medicina Social Universidade do Estado do Rio de Janeiro (UERJ) Rio de JaneiroRJ Brasil Universidade do Estado do Rio de Janeiro (UERJ), Instituto de Medicina Social, Rio de Janeiro (RJ), Brasil.

出版信息

Rev Panam Salud Publica. 2019 Feb 6;43:e19. doi: 10.26633/RPSP.2019.19. eCollection 2019.

Abstract

OBJECTIVE

To investigate the impact of combined use of fixed and mobile mammography units to rationalize the management of breast cancer screening programs and increase population coverage.

METHODS

An observational study was performed using agents-based modeling. The model was used to simulate breast cancer screening coverage in a specific region in the state of Rio de Janeiro () where 22 fixed mammography units are installed. The number and distribution of fixed and mobile units, as well as the required number of daily exams, were estimated considering a population coverage of 100% and 60% in the region for the 2015-2016 biennium.

RESULTS

For the two-year period, a 60% population coverage could be reached with eight mammography units (five fixed and three mobile). Considering a scenario in which 100% of the eligible population would undergo screening, 11 units would be required (seven fixed and four mobile units). The actual coverage in the region for the 2015-2016 biennium was 36.4%, with 22 mammography units performing four exams daily.

CONCLUSIONS

The present simulation showed that it would be possible to reduce by half the number of mammography units in the region, ensuring 100% coverage. Adding more mobile units would facilitate access by the population from cities without installed mammography units and from rural areas.

摘要

目的

探讨联合使用固定式和移动式乳腺钼靶设备对优化乳腺癌筛查项目管理及提高人群覆盖率的影响。

方法

采用基于主体的建模方法进行一项观察性研究。该模型用于模拟里约热内卢州某特定地区的乳腺癌筛查覆盖率,该地区安装了22台固定式乳腺钼靶设备。在考虑2015 - 2016两年期该地区100%和60%的人群覆盖率的情况下,估算了固定式和移动式设备的数量及分布,以及每日所需检查数量。

结果

在两年期间,8台乳腺钼靶设备(5台固定式和3台移动式)可实现60%的人群覆盖率。若考虑100%的 eligible 人群都接受筛查的情况,则需要11台设备(7台固定式和4台移动式)。2015 - 2016两年期该地区的实际覆盖率为36.4%,22台乳腺钼靶设备每日进行4次检查。

结论

目前的模拟结果表明,该地区乳腺钼靶设备数量可减少一半,同时确保100%的覆盖率。增加更多的移动式设备将便于未安装乳腺钼靶设备的城市及农村地区的人群进行检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e678/6459392/cc28e800e058/rpsp-43-e19_Figure1.jpg

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