Kaiser Permanente Washington Health Research Institute, Seattle, Washington.
Department of Epidemiology, University of Washington, Seattle, Washington.
Cancer Epidemiol Biomarkers Prev. 2022 Aug 2;31(8):1517-1520. doi: 10.1158/1055-9965.EPI-22-0232.
The effectiveness and efficiency of cancer screening in real-world settings depend on many factors, including test sensitivity and specificity. Outside of select experimental studies, not everyone receives a gold standard test that can serve as a comparator in estimating screening test accuracy. Thus, many studies of screening test accuracy use the passage of time to infer whether or not cancer was present at the time of the screening test, particularly for patients with a negative screening test. We define the accuracy assessment interval as the period of time after a screening test that is used to estimate the test's accuracy. We describe how the length of this interval may bias sensitivity and specificity estimates. We call for future research to quantify bias and uncertainty in accuracy estimates and to provide guidance on setting accuracy assessment interval lengths for different cancers and screening modalities.
癌症筛查在真实环境中的有效性和效率取决于许多因素，包括检测的灵敏度和特异性。除了一些特定的实验研究外，并非每个人都接受金标准测试，该测试可用作估计筛查测试准确性的对照。因此，许多筛查测试准确性的研究都使用时间推移来推断在进行筛查测试时是否存在癌症，特别是对于筛查测试呈阴性的患者。我们将准确性评估间隔定义为从筛查测试后用于估计测试准确性的时间段。我们描述了这个间隔的长度如何影响灵敏度和特异性估计的偏倚。我们呼吁未来的研究量化准确性估计中的偏差和不确定性，并为不同癌症和筛查方式的准确性评估间隔长度提供指导。
