Jansen J T, Zoetelief J
TNO-ME Radiological Service, Centre for Radiological Protection and Dosimetry, Arnhem, The Netherlands.
Br J Radiol. 1995 Feb;68(806):141-9. doi: 10.1259/0007-1285-68-806-141.
Breast cancer screening programmes employing mammography are being implemented in various European countries. Different screening protocols are used in demonstration projects and nationwide programmes. To evaluate and improve protocols, a computer model for the evaluation of breast cancer screening has been developed. The availability of such a model can be of great importance in obtaining a better insight into the influence of various parameters. The Monte Carlo computer model is based on random selection from distributions of relevant parameters including tumour onset, tumour growth rate, lifetime expectancy, tumour detection size for screening and spontaneous observation. The radiation risk is calculated for various screening protocols employing multiplicative and additive risk models combined with lifetime expectancy, number of females screened and absorbed dose per screening session. The benefit is calculated on the basis of the reduction in tumour size at detection due to screening compared with spontaneous observation and the survival as a function of tumour diameter. Data from the Swedish two-county study are used to validate the model in terms of prevalence, interval tumour rates and interval tumour diameter distributions. Except for the spontaneous tumour diameter distribution, the model can describe the Swedish two-county study. Specific information is presented on the distributions of relevant parameters.
欧洲各国正在实施采用乳房X线摄影术的乳腺癌筛查项目。示范项目和全国性项目采用了不同的筛查方案。为了评估和改进这些方案，已开发出一种用于评估乳腺癌筛查的计算机模型。这种模型的可用性对于更好地了解各种参数的影响可能非常重要。蒙特卡洛计算机模型基于从包括肿瘤发生、肿瘤生长速率、预期寿命、筛查的肿瘤检测大小和自然观察等相关参数的分布中进行随机选择。使用乘法和加法风险模型结合预期寿命、接受筛查的女性数量以及每次筛查的吸收剂量，计算各种筛查方案的辐射风险。根据筛查与自然观察相比检测时肿瘤大小的减小以及作为肿瘤直径函数的生存率来计算益处。瑞典两县研究的数据用于在患病率、间期肿瘤率和间期肿瘤直径分布方面验证该模型。除了自然肿瘤直径分布外，该模型可以描述瑞典两县研究。文中给出了相关参数分布的具体信息。
