Miller A B
Department of Preventive Medicine and Biostatistics, University of Toronto, Ontario, Canada.
Ann Epidemiol. 1994 Mar;4(2):96-101. doi: 10.1016/1047-2797(94)90053-1.
Many organizations in the United States recommend mammography screening at 1- to 2-year intervals for those 40 to 49 years old. In most areas of Canada and Europe, screening mammography is not recommended for women 40 to 49 years old. These differences have arisen over interpretation of data from the Health Insurance Plan (HIP) study and the Breast Cancer Detection Demonstration Project (BCDDP). The apparent benefit in the HIP study is probably attributable to poor survival of control subjects with stage 1 cancers. In the BCDDP, although high cancer detection rates by mammography and improved survival of patients with screen-detected cancer were seen, the latter was probably largely due to lead time bias. The screening studies in Canada and Europe show no evidence of effectiveness of mammography screening in women 40 to 49 years old, at least in the first 10 years after screening is initiated. For women over 65 there are few data, but screening to age 74 is probably appropriate.
美国的许多组织建议40至49岁的女性每1至2年进行一次乳房X光检查筛查。在加拿大和欧洲的大部分地区，不建议40至49岁的女性进行乳房X光检查筛查。这些差异源于对健康保险计划（HIP）研究和乳腺癌检测示范项目（BCDDP）数据的解读。HIP研究中明显的益处可能归因于1期癌症对照受试者的低生存率。在BCDDP中，尽管乳房X光检查的癌症检出率很高，且筛查发现癌症的患者生存率有所提高，但后者可能主要是由于领先时间偏倚。加拿大和欧洲的筛查研究表明，没有证据显示乳房X光检查筛查对40至49岁的女性有效，至少在开始筛查后的头10年是这样。对于65岁以上的女性，数据很少，但筛查至74岁可能是合适的。
