Paci E, Boer R, Zappa M, de Koning H J, van Oortmarssen G J, Crocetti E, Giorgi D, Rosselli del Turco M, Habbema J D
Unit of Epidemiology, Center for the Study and Prevention of Cancer, Florence, Italy.
Eur J Cancer. 1995;31A(3):348-53. doi: 10.1016/0959-8049(95)94001-f.
The efficacy of breast cancer screening for women older than 50 years has been shown in several studies. Service screening is now ongoing or planned in several countries in Europe. MISCAN, a computer simulation programme, has been used to analyse data from the Florence District Programme (FDP) breast cancer experience. First, the model was fitted to the screening results for the period 1975-1986. A good correspondence between the model outcomes and the FDP results was achieved. It was then used to predict the impact on mortality of the new starting programme of the city of Florence (63,000 women, 50-69 years old). Assuming a 70% attendance rate, then for the city of Florence, 2563 screen-detected breast cancers are predicted for the period 1991-2020 out of the total number of 9095 breast cancers for all ages (28%). A total of 3720 deaths for breast cancer are expected without screening. An absolute reduction of 472 deaths (13%) is predicted for the whole population. The estimated number of years of life gained by screening until 2020 is 4354. Simulation by MISCAN has previously been a useful support tool for decision-making about screening. The present paper is the first based on a southern European experience. The possibility of applying MISCAN to predict the impact of a national programme in Italy is discussed.
多项研究已表明，针对50岁以上女性的乳腺癌筛查具有成效。目前，欧洲多个国家正在开展或计划开展服务性筛查。MISCAN是一个计算机模拟程序，已被用于分析佛罗伦萨地区项目（FDP）的乳腺癌筛查数据。首先，该模型与1975年至1986年期间的筛查结果进行拟合。模型结果与FDP结果之间取得了良好的一致性。随后，该模型被用于预测佛罗伦萨市新启动项目（63000名50至69岁女性）对死亡率的影响。假设参与率为70%，那么对于佛罗伦萨市，在1991年至2020年期间，预计在所有年龄段的9095例乳腺癌中，通过筛查发现2563例（占28%）。若不进行筛查，预计乳腺癌死亡总数为3720例。预计整个人口的乳腺癌死亡绝对数减少472例（13%）。到2020年，通过筛查预计获得的生命年数为4354年。此前，MISCAN模拟一直是筛查决策的有用支持工具。本文是第一篇基于南欧经验的文章。文中还讨论了应用MISCAN预测意大利国家项目影响的可能性。
