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风险调整后的乳腺筛查:澳大利亚视角及西太平洋地区的考量

Risk-adjusted breast screening: an Australian perspective and considerations for the Western Pacific.

作者信息

Nickson Carolyn, Velentzis Louiza S, Mann G Bruce, Grogan Paul, Bateson Deborah, Canfell Karen

机构信息

The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney 2006, NSW, Australia.

Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC 3010, Australia.

出版信息

Lancet Reg Health West Pac. 2025 Mar 19;57:101520. doi: 10.1016/j.lanwpc.2025.101520. eCollection 2025 Apr.

DOI:10.1016/j.lanwpc.2025.101520
PMID:40443539
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12121426/
Abstract

Breast cancer is the most common cancer in females globally, and the leading cause of female cancer deaths. The 2023 World Health Organisation Global Breast Cancer Initiative Framework aims to prevent 2·5 million deaths from breast cancer by 2040. Early detection of breast cancer is central to this goal, and population-based breast screening is key to early detection. A more risk-adjusted approach to screening within current target age ranges, whether risk-stratified (tailoring population-wide screening protocols based on risk) or risk-targeted (prioritising available screening services to higher risk females) is likely to prevent further deaths. This article presents a review of the risk-adjusted screening initiative in Australia (the Roadmap to Optimising Screening in Australia (ROSA) Project) and explores a potential framework for advancing risk-adjusted strategies for breast screening throughout the Western Pacific region.

摘要

乳腺癌是全球女性中最常见的癌症,也是女性癌症死亡的主要原因。《2023年世界卫生组织全球乳腺癌倡议框架》旨在到2040年预防250万例乳腺癌死亡。乳腺癌的早期检测是这一目标的核心,而基于人群的乳腺筛查是早期检测的关键。在当前目标年龄范围内采用更具风险调整的筛查方法,无论是风险分层(根据风险制定全人群筛查方案)还是风险靶向(将可用筛查服务优先提供给高风险女性),都有可能预防更多死亡。本文对澳大利亚的风险调整筛查倡议(澳大利亚优化筛查路线图(ROSA)项目)进行了综述,并探讨了在整个西太平洋地区推进乳腺筛查风险调整策略的潜在框架。

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Benefits and harms of polygenic risk scores in organised cancer screening programmes: a cost-effectiveness analysis.多基因风险评分在有组织的癌症筛查项目中的利弊:一项成本效益分析。
Lancet Reg Health West Pac. 2024 Jan 22;44:101012. doi: 10.1016/j.lanwpc.2024.101012. eCollection 2024 Mar.
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Acceptability and appropriateness of a risk-tailored organised melanoma screening program: Qualitative interviews with key informants.风险定制化的有组织黑色素瘤筛查项目的可接受性和适宜性:关键信息提供者的定性访谈。
PLoS One. 2023 Dec 13;18(12):e0287591. doi: 10.1371/journal.pone.0287591. eCollection 2023.
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Cancer screening in China: a steep road from evidence to implementation.中国的癌症筛查:从证据到实施的艰难之路。
Lancet Public Health. 2023 Dec;8(12):e996-e1005. doi: 10.1016/S2468-2667(23)00186-X. Epub 2023 Nov 21.
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Artificial Intelligence-Driven Mammography-Based Future Breast Cancer Risk Prediction: A Systematic Review.基于人工智能驱动的乳腺钼靶摄影的未来乳腺癌风险预测:一项系统综述。
J Am Coll Radiol. 2024 Feb;21(2):319-328. doi: 10.1016/j.jacr.2023.10.018. Epub 2023 Nov 8.
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Benefits and harms of breast cancer screening: Cohort study of breast cancer mortality and overdiagnosis.乳腺癌筛查的益处与危害:乳腺癌死亡率及过度诊断的队列研究
Cancer Med. 2023 Sep;12(17):18120-18132. doi: 10.1002/cam4.6373. Epub 2023 Aug 7.
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