Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
National Institute for Health Development, Tallinn, Estonia.
Int J Cancer. 2021 Jan 15;148(2):406-418. doi: 10.1002/ijc.33204. Epub 2020 Jul 30.
Currently, all European countries offer some form of breast cancer screening. Nevertheless, disparities exist in the status of implementation, attendance and the extent of opportunistic screening. As a result, breast cancer screening has not yet reached its full potential. We examined how many breast cancer deaths could be prevented if all European countries would biennially screen all women aged 50 to 69 for breast cancer. We calculated the number of breast cancer deaths already prevented due to screening as well as the number of breast cancer deaths which could be additionally prevented if the total examination coverage (organised plus opportunistic) would reach 100%. The calculations are based on total examination coverage in women aged 50 to 69, the annual number of breast cancer deaths for women aged 50 to 74 and the maximal possible mortality reduction from breast cancer, assuming similar effectiveness of organised and opportunistic screening. The total examination coverage ranged from 49% (East), 62% (West), 64% (North) to 69% (South). Yearly 21 680 breast cancer deaths have already been prevented due to mammography screening. If all countries would reach 100% examination coverage, 12 434 additional breast cancer deaths could be prevented annually, with the biggest potential in Eastern Europe. With maximum coverage, 23% of their breast cancer deaths could be additionally prevented, while in Western Europe it could be 21%, in Southern Europe 15% and in Northern Europe 9%. Our study illustrates that by further optimising screening coverage, the number of breast cancer deaths in Europe can be lowered substantially.
目前，所有欧洲国家都提供某种形式的乳腺癌筛查。然而，在实施情况、参与程度和机会性筛查程度方面存在差异。因此，乳腺癌筛查尚未发挥其全部潜力。我们研究了如果所有欧洲国家都对 50 至 69 岁的所有女性每两年进行一次乳腺癌筛查，那么有多少乳腺癌死亡可以预防。我们计算了已经通过筛查预防的乳腺癌死亡人数，以及如果总检查覆盖率（有组织的加机会性的）达到 100%，可以额外预防的乳腺癌死亡人数。这些计算基于 50 至 69 岁女性的总检查覆盖率、50 至 74 岁女性每年的乳腺癌死亡人数以及假设组织性和机会性筛查同样有效的情况下乳腺癌死亡率最大可能降低的情况。总检查覆盖率从东部的 49%（东欧）、西部的 62%、北部的 64%到南部的 69%不等。每年已经有 21680 例乳腺癌死亡是通过乳房 X 线照相术筛查预防的。如果所有国家都达到 100%的检查覆盖率，每年可以额外预防 12434 例乳腺癌死亡，东欧的潜力最大。在最大覆盖率的情况下，其乳腺癌死亡人数可额外减少 23%，而在西欧为 21%，在南欧为 15%，在北欧为 9%。我们的研究表明，通过进一步优化筛查覆盖率，可以大大降低欧洲的乳腺癌死亡人数。
