Wun L M, Feuer E J, Miller B A
Surveillance Program of the National Cancer Institute, Bethesda 20892, USA.
Cancer Causes Control. 1995 Mar;6(2):135-44. doi: 10.1007/BF00052774.
A number of studies have attributed much of the sharp increase in breast cancer incidence in the United States during the 1980s to the increased detection through mammography. The most recent breast cancer data from the US National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program show that the incidence trend has slowed, while results from the National Health Interview Survey (NHIS) of 1987 and 1990 indicate that the percentage of women receiving mammograms continues to increase. This phenomenon suggested the need to reassess the relationship between increasingly early detection of breast cancer and overall incidence trends. A polynomial age-cohort model was used to establish the secular trend in incidence rates excluding the impact of recent increases in detection due to the rising use of mammography. Based on the model, the incidence trend in the youngest age group (40 to 49 years) would peak and then begin to decline in the early 1980s. This pattern would manifest itself later in successively older age groups as these younger cohorts age. Breast cancer trends are seen to be generally consistent with the impact of the increased use of mammography when its effect is superimposed upon the background of declining or slowing secular trends. These results support previous reports linking incidence rates with the increase in screening-mammography.
一些研究将20世纪80年代美国乳腺癌发病率的大幅上升主要归因于乳房X线摄影术检测的增加。美国国家癌症研究所的监测、流行病学和最终结果（SEER）计划的最新乳腺癌数据显示，发病率趋势有所放缓，而1987年和1990年的国家健康访谈调查（NHIS）结果表明，接受乳房X线摄影检查的女性比例持续上升。这一现象表明有必要重新评估乳腺癌早期检测增加与总体发病率趋势之间的关系。使用多项式年龄队列模型来确定发病率的长期趋势，排除因乳房X线摄影术使用增加导致近期检测增加的影响。根据该模型，最年轻年龄组（40至49岁）的发病率趋势将在20世纪80年代初达到峰值，然后开始下降。随着这些较年轻队列的变老，这种模式将在相继较年长的年龄组中稍后显现出来。当乳房X线摄影术使用增加的影响叠加在长期下降或放缓趋势的背景上时，乳腺癌趋势总体上与乳房X线摄影术使用增加的影响一致。这些结果支持了先前将发病率与乳房X线摄影筛查增加联系起来的报告。
