Lindgren A
Department of Pathology, Academic Hospital, Uppsala, Sweden.
Qual Assur Health Care. 1993 Dec;5(4):303-7. doi: 10.1093/intqhc/5.4.303.
Four randomized Swedish studies on the usefulness of mammography in screening for breast cancer have been published. The results have shown a variable but positive effect of screening in women more than 50 years of age but the effect is questionable before this age. The protocol and end points however differ between the studies and in order to summarize the results of the present studies, an unbiased, blinded end-point committee was created. The results of this study have been published recently. The present communication only concerns the role of autopsy in this study. The deaths of 1367 patients with a diagnosis of breast cancer have been studied. The percentage of autopsy varied from 21 to 74% between the four studies. When autopsy was performed, 58% were found to have died from breast cancer, 13% from other malignancies and the rest from other diseases. In cases with no autopsy, 73% were considered to have died of breast cancer and 9% of other malignancies. Deaths due to other cancers included a surprising number of cancers of the stomach, gallbladder and pancreas, two to three times higher than expected.
瑞典已发表了四项关于乳房X线摄影术在乳腺癌筛查中作用的随机研究。结果显示，筛查对50岁以上女性有不同程度但积极的效果，但在该年龄之前效果存疑。然而，这些研究的方案和终点不同，为了总结当前研究的结果，成立了一个无偏倚、盲法的终点委员会。这项研究的结果最近已发表。本通讯仅涉及尸检在本研究中的作用。已对1367例诊断为乳腺癌的患者的死亡情况进行了研究。四项研究中尸检的比例从21%到74%不等。进行尸检时，发现58%死于乳腺癌，13%死于其他恶性肿瘤，其余死于其他疾病。在未进行尸检的病例中，73%被认为死于乳腺癌，9%死于其他恶性肿瘤。死于其他癌症的病例中，胃癌、胆囊癌和胰腺癌的数量惊人，比预期高出两到三倍。
