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丹麦一项队列研究:长达 12-14 年随访的假阳性筛查性乳房 X 光摄影的长期心理社会后果。

Long-term psychosocial consequences of false-positive screening mammography: a cohort study with follow-up of 12-14 years in Denmark.

机构信息

Center of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark

Primary Health Care Research Unit, Region Zealand, Denmark.

出版信息

BMJ Open. 2023 Apr 26;13(4):e072188. doi: 10.1136/bmjopen-2023-072188.

Abstract

OBJECTIVE

To compare the long-term psychosocial consequences of mammography screening among women with breast cancer, normal results and false-positive results.

DESIGN

A matched cohort study with follow-up of 12-14 years.

SETTING

Denmark from 2004 to 2019.

PARTICIPANTS

1170 women who participated in the Danish mammography screening programme in 2004-2005.

INTERVENTION

Mammography screening for women aged 50-69 years.

OUTCOME MEASURES

We assessed the psychosocial consequences with the Consequences Of Screening-Breast Cancer, a condition-specific questionnaire that is psychometrically validated and encompasses 14 psychosocial dimensions.

RESULTS

Across all 14 psychosocial outcomes, women with false-positive results averagely reported higher psychosocial consequences compared with women with normal findings. Mean differences were statistically insignificant except for the existential values scale: 0.61 (95% CI (0.15 to 1.06), p=0.009). Additionally, women with false-positive results and women diagnosed with breast cancer were affected in a dose-response manner, where women diagnosed with breast cancer were more affected than women with false-positive results.

CONCLUSION

Our study suggests that a false-positive mammogram is associated with increased psychosocial consequences 12-14 years after the screening. This study adds to the harms of mammography screening. The findings should be used to inform decision-making among the invited women and political and governmental decisions about mammography screening programmes.

摘要

目的

比较乳腺癌、正常结果和假阳性结果女性接受乳腺 X 线筛查后的长期心理社会后果。

设计

一项匹配队列研究,随访 12-14 年。

地点

丹麦,2004 年至 2019 年。

参与者

1170 名参加 2004-2005 年丹麦乳腺 X 线筛查计划的女性。

干预措施

对 50-69 岁女性进行乳腺 X 线筛查。

结局指标

我们使用经过心理测量验证的特定于疾病的问卷“筛查后乳腺癌的后果”来评估心理社会后果,该问卷包含 14 个心理社会维度。

结果

在所有 14 个心理社会结果中,与正常结果相比,假阳性结果的女性平均报告的心理社会后果更高。除生存价值观量表外,平均差异无统计学意义:0.61(95%CI(0.15 至 1.06),p=0.009)。此外,假阳性结果和乳腺癌诊断的女性呈剂量反应关系,乳腺癌诊断的女性受影响程度大于假阳性结果的女性。

结论

我们的研究表明,假阳性乳腺 X 线检查与筛查后 12-14 年心理社会后果增加有关。本研究增加了乳腺 X 线筛查的危害。这些发现应用于为受邀女性做出决策以及为政府和政府关于乳腺 X 线筛查计划的决策提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2589/10151842/16c76e7ec9c4/bmjopen-2023-072188f01.jpg

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