Section for Breast Cancer Screening, Cancer Registry of Norway, Postbox 5313, Majorstuen, 0304, Oslo, Norway.
Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.
Eur J Epidemiol. 2020 Jun;35(6):549-556. doi: 10.1007/s10654-020-00645-0. Epub 2020 May 19.
We questioned whether a history of negative screening outcomes could be used to predict breast cancer risk, and thus be used as a potential factor for stratification of mammographic screening. Data from the Norwegian population based breast cancer screening program, BreastScreen Norway, was used to estimate cumulative hazard rates for breast cancer by number of prior negative screening outcomes among participants from 1995 through 2016. We followed three age cohorts of women, who started screening at age 50-54, 55-59, and 60-64 years. Further, we estimated the absolute and relative risk of breast cancer by number of prior negative screening outcomes. The cumulative hazard curves were parallel for all numbers of negative screening outcomes for all age cohorts. The absolute risk of breast cancer increased with number of negative screening outcomes for the youngest age cohort. For the oldest age cohorts, the absolute risk was stable during the screening period and decreased thereafter. The number of negative screening outcomes was not associated with risk of breast cancer, adjusted for age, percent screening attendance and calendar years (HR 1.00, 95% CI 0.98-1.02). Our results suggest that the number of negative screening outcomes does not predict breast cancer risk among participants in BreastScreen Norway.
我们质疑阴性筛查结果的历史是否可以用于预测乳腺癌风险，从而作为乳腺筛查分层的潜在因素。使用来自挪威基于人群的乳腺癌筛查计划（挪威乳腺筛查项目）的数据，通过对 1995 年至 2016 年期间参与者的先前阴性筛查结果数量来估计乳腺癌的累积危险率。我们随访了三个年龄队列的女性，她们分别在 50-54 岁、55-59 岁和 60-64 岁开始筛查。此外，我们根据先前的阴性筛查结果数量来估计乳腺癌的绝对风险和相对风险。对于所有年龄队列，所有阴性筛查结果数量的累积危险曲线都是平行的。对于最年轻的年龄队列，随着阴性筛查结果数量的增加，乳腺癌的绝对风险增加。对于最年长的年龄队列，在筛查期间，绝对风险保持稳定，之后则下降。对于年龄、筛查参与率和日历年份进行调整后，阴性筛查结果的数量与乳腺癌风险无关（HR 1.00，95%CI 0.98-1.02）。我们的研究结果表明，在挪威乳腺筛查项目中，阴性筛查结果的数量并不能预测参与者的乳腺癌风险。
