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2014 年至 2021 年意大利关于乳腺 X 光筛查的在线信息。

Online information about mammography screening in Italy from 2014 to 2021.

机构信息

Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Luciano Armanni, 5, 80138, Naples, Italy.

出版信息

BMC Womens Health. 2022 Apr 27;22(1):132. doi: 10.1186/s12905-022-01718-w.

DOI:10.1186/s12905-022-01718-w
PMID:35477449
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9044849/
Abstract

BACKGROUND

Many studies have reported that the information women receive about the risk-to-benefit ratio of breast cancer screening is still scarce and biased toward benefit. In a study we conducted in 2014, we analysed online documents about breast cancer screening that were addressed to the general female public. In the present study, we used the same methodology to verify if the information provided to women was improved.

METHODS

We evaluated documents addressed to the general female public and posted on the Internet by the Italian national and regional public health services. False-positive and false-negative screening results, biopsy-proven false-positive results, interval cancer, overdiagnosis, radiation exposure, and decrease in risk of mortality were analysed. In addition, quantitative data were searched.

RESULTS

In 2021, the most frequently reported information was reduction in breast cancer mortality (58.2%). The most frequently reported risk was a false-positive mammogram (42.5%). Similar frequency rates were reported for interval cancer, false-negative result, and radiation exposure (35.8%, 31.3%, and 28.3%, respectively). Overdiagnosis and biopsy-proven false-positive result were the less reported risks (20.1% and 10.4%). Thirteen documents provided quantitative data about reduction of mortality risk (16.7%), and only 19 provided quantitative data about risks or harms (8.4%). Almost all organisations sent letters of invitation to women (92.5%) and provided screening free of charge (92.5%). The most recommended was biennial screening for women aged between 50 and 69 years (48.5%). Compared with the information in 2014, that in 2021 showed some improvements. The most marked improvements were in the numbers of reports on overdiagnosis, which increased from 8.0 to 20.1%, and biopsy-proven false-positive result, which increased from 1.4 to 10.4%. Regarding the benefits of breast cancer screening, reduced mortality risk became increasingly reported from 2014 (34.5%) to 2021 (58.2%). Conversely, quantitative data remained scarce in 2021.

CONCLUSIONS

Moderate improvements in information were observed from 2014 to 2021. However, the information on breast cancer screening in documents intended for women published on Italian websites remain scarce.

摘要

背景

许多研究报告指出,女性获得的关于乳腺癌筛查风险效益比的信息仍然匮乏且偏向于效益。在我们 2014 年进行的一项研究中,我们分析了针对普通女性公众的在线乳腺癌筛查文件。在本研究中,我们使用相同的方法来验证提供给女性的信息是否有所改善。

方法

我们评估了意大利国家和地区公共卫生服务机构在互联网上发布的针对普通女性公众的文件。分析了假阳性和假阴性筛查结果、活检证实的假阳性结果、间期癌、过度诊断、辐射暴露和死亡率降低等内容。此外,还搜索了定量数据。

结果

2021 年,报告最频繁的信息是乳腺癌死亡率降低(58.2%)。报告最频繁的风险是假阳性乳房 X 光片(42.5%)。间期癌、假阴性结果和辐射暴露的报告频率相似(分别为 35.8%、31.3%和 28.3%)。过度诊断和活检证实的假阳性结果是报告较少的风险(20.1%和 10.4%)。13 份文件提供了关于死亡率降低风险的定量数据(16.7%),只有 19 份文件提供了关于风险或危害的定量数据(8.4%)。几乎所有组织都向女性发出了邀请信(92.5%)并提供免费筛查(92.5%)。最推荐的是 50 至 69 岁女性每两年进行一次筛查(48.5%)。与 2014 年相比,2021 年的信息显示出一些改进。最显著的改进是过度诊断的报告数量增加,从 2014 年的 8.0%增加到 2021 年的 20.1%,以及活检证实的假阳性结果,从 2014 年的 1.4%增加到 2021 年的 10.4%。关于乳腺癌筛查的益处,从 2014 年的 34.5%到 2021 年的 58.2%,降低死亡率的风险报告越来越多。相反,2021 年定量数据仍然很少。

结论

从 2014 年到 2021 年,信息有适度的改善。然而,意大利网站上发布的针对女性的文件中关于乳腺癌筛查的信息仍然匮乏。

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BMC Public Health. 2021 Jul 3;21(1):1301. doi: 10.1186/s12889-021-11360-0.
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Informing Women About Overdetection in Breast Cancer Screening: Two-Year Outcomes From a Randomized Trial.在乳腺癌筛查中告知女性过度检测:一项随机试验的两年结果。
J Natl Cancer Inst. 2021 Nov 2;113(11):1523-1530. doi: 10.1093/jnci/djab083.
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Breast cancer screening knowledge among Hungarian women: a cross-sectional study.匈牙利女性的乳腺癌筛查知识:一项横断面研究。
BMC Womens Health. 2021 Feb 15;21(1):69. doi: 10.1186/s12905-021-01204-9.
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Breast Cancer Screening Trials: Endpoints and Overdiagnosis.乳腺癌筛查试验:终点和过度诊断。
J Natl Cancer Inst. 2021 Sep 4;113(9):1131-1135. doi: 10.1093/jnci/djaa140.
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A dynamic web-based decision aid to improve informed choice in organised breast cancer screening. A pragmatic randomised trial in Italy.一个基于动态网络的决策辅助工具,用于提高有组织的乳腺癌筛查中的知情选择。意大利的一项实用随机试验。
Br J Cancer. 2020 Sep;123(5):714-721. doi: 10.1038/s41416-020-0935-2. Epub 2020 Jun 17.
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Current Guidelines and Gaps in Breast Cancer Screening.乳腺癌筛查的现行指南与差距
J Am Coll Radiol. 2020 Oct;17(10):1269-1275. doi: 10.1016/j.jacr.2020.05.002. Epub 2020 May 28.
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Use of an Online Breast Cancer Risk Assessment and Patient Decision Aid in Primary Care Practices.在线乳腺癌风险评估和患者决策辅助工具在初级保健实践中的应用。
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