Zuur C, Broerse J J
Diagn Imaging Clin Med. 1985;54(3-4):211-22.
Risk- and cost benefit analyses for breast screening programs are being performed, employing the risk-factors for induction of breast cancer from six extensive follow-up studies. For women of the age group above 35 years and for a risk period of 30 years after a 10-year latency period, a factor of extra cases of 20 X 10(-6) mGy-1 can be estimated. This factor is by coincidence the same as the factor estimated by the Committee on the Biological Effects of Ionizing Radiations and by United Nations Scientific Committee on the Effects of Atomic Radiation for women above 20 years, and would have been about a factor 2 lower for the category older than 35 years. Measurements are being performed in Dutch hospitals to determine the mean absorbed tissue dose. These doses vary from 0.6 to 4.4 mGy per radiograph. For a dose of 1 mGy per radiograph (which can easily be achieved) and yearly screening of women between 35 and 75 years, the risk of radiogenic breast cancer is about 1% of the natural incidence (85,000 per 10(6) women) in this group. A recommended frequency of screening has to be based on medical, social and financial considerations. The gain in woman years and in completely cured women is being estimated for screening with intervals of 12 instead of 24 months. This estimation is based on the frequencies of the tumour diameters after 12 and 24 months intervals and the survival percentages for these tumour diameters. The medical and social benefit is 1,520 years life-time and 69 more cases completely cured per 1,000 breast cancer patients. The financial profit of a completely cured instead of an ultimately fatal cancer can be roughly estimated at 55,000 guilders. In addition the costs per gained woman-year are about 5,000 guilders (1 US $ = 3.60 guilders). In consequence, the extra costs of annual additional rounds of mammographic screening are balanced by the benefit.
正在利用六项大规模随访研究中诱发乳腺癌的风险因素，对乳腺筛查项目进行风险和成本效益分析。对于35岁以上年龄组的女性以及10年潜伏期后的30年风险期，可估计出每毫戈瑞（mGy）额外病例数为20×10⁻⁶的系数。巧合的是，这个系数与电离辐射生物效应委员会以及联合国原子辐射影响科学委员会为20岁以上女性估计的系数相同，对于35岁以上的类别，该系数本应低约2倍。荷兰医院正在进行测量，以确定平均组织吸收剂量。每张X光片的这些剂量在0.6至4.4毫戈瑞之间变化。对于每张X光片剂量为1毫戈瑞（这很容易实现）且对35至75岁女性进行年度筛查的情况，放射性乳腺癌的风险约为此组自然发病率（每10⁶名女性中有85,000例）的1%。推荐的筛查频率必须基于医学、社会和经济方面的考虑。正在估计以12个月而非24个月的间隔进行筛查时，女性生命年数和完全治愈女性数量的增加。该估计基于12个月和24个月间隔后肿瘤直径的频率以及这些肿瘤直径的生存率。医疗和社会效益为每1000名乳腺癌患者有1520个生命年和69例更多完全治愈的病例。完全治愈而非最终致命癌症的经济收益可大致估计为55,000荷兰盾。此外，每增加一个女性生命年的成本约为5000荷兰盾（1美元 = 3.60荷兰盾）。因此，每年额外一轮乳腺钼靶筛查的额外成本与效益相平衡。
