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荷兰乳腺癌筛查项目中参加女性筛查性和间隔性癌症的发病率、特征和预后的长期趋势。

Long-term trends in incidence, characteristics and prognosis of screen-detected and interval cancers in women participating in the Dutch breast cancer screening programme.

机构信息

Department of Epidemiology, Maastricht University, Maastricht, the Netherlands.

Department of Radiology, Canisius Wilhelmina Hospital, Nijmegen, the Netherlands.

出版信息

Br J Cancer. 2024 May;130(9):1561-1570. doi: 10.1038/s41416-024-02633-7. Epub 2024 Mar 11.

Abstract

BACKGROUND

No studies are available in which changes over time in characteristics and prognosis of patients with interval breast cancers (ICs) and screen-detected breast cancers (SDCs) have been compared. The aim was to study these trends between 1995 and 2018.

METHODS

All women with invasive SDCs (N = 4290) and ICs (N = 1352), diagnosed in a southern mammography screening region in the Netherlands, were included and followed until date of death or 31 December 2022.

RESULTS

The 5-year overall survival rate of women with SDCs increased from 91.4% for those diagnosed in 1995-1999 to 95.0% for those diagnosed in 2013-2018 (P < 0.001), and from 74.8 to 91.6% (P < 0.001) in the same periods for those with ICs. A similar trend was observed for the 10-year survival rates. After adjustment for changes in tumour characteristics, the hazard ratio (HR) for overall survival was 0.47 (95% confidence interval (CI): 0.38-0.59) for women with SDCs diagnosed in the period 2013-2018, compared to the women diagnosed in the period 1995-1999. For the women with ICs this HR was 0.27 (95% CI: 0.19-0.40).

CONCLUSION

The prognosis of women with ICs has improved rapidly since 1995 and is now almost similar to that of women with SDCs.

摘要

背景

目前尚无研究比较随时间推移,间隔期乳腺癌(IC)和筛查期乳腺癌(SDC)患者特征和预后的变化。本研究旨在比较 1995 年至 2018 年期间的这些变化趋势。

方法

所有在荷兰南部一个乳腺筛查区域诊断为浸润性 SDC(N=4290)和 IC(N=1352)的女性患者均纳入本研究,并随访至死亡或 2022 年 12 月 31 日。

结果

SDC 患者的 5 年总生存率从 1995-1999 年诊断患者的 91.4%提高到 2013-2018 年诊断患者的 95.0%(P<0.001),IC 患者的生存率从 74.8%提高到 91.6%(P<0.001)。在同一时期,10 年生存率也呈现出类似的趋势。经肿瘤特征变化调整后,与 1995-1999 年诊断的患者相比,2013-2018 年诊断的 SDC 患者的总生存风险比(HR)为 0.47(95%可信区间(CI):0.38-0.59)。IC 患者的 HR 为 0.27(95% CI:0.19-0.40)。

结论

自 1995 年以来,IC 患者的预后迅速改善,目前与 SDC 患者的预后几乎相似。

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