Brekelmans C T, Peeters P H, Deurenberg J J, Collette H J
Department of Epidemiology, University of Utrecht, The Netherlands.
Eur J Cancer. 1995 Oct;31A(11):1830-5. doi: 10.1016/0959-8049(95)00324-c.
The study describes breast cancer survival of 75 interval cancer cases (cancer occurring within 2 years of a negative screen) detected in women who participated in the DOM screening programme. After mammographic revision, this group was divided into 17 so-called 'missed' cases and 58 'true' interval cases. Ten year survival of these 58 'true' interval cases was 58%, which was not significantly different from that of 219 cancers detected in a non-screened, control group of women, diagnosed with breast cancer before the start of screening (63%; log rank chi 2 test, P = 0.98). Results remained essentially the same after correction for age at diagnosis, tumour size, axillary status and year of diagnosis. Ten year survival of 'true' interval cancers (58%) was slightly worse than that of 'missed' cases (67%; log rank chi 2 test: P = 0.38). This difference could largely be explained by differences in tumour size and axillary status. We conclude that there was no important difference in survival between 'true' interval cancers and non-screened historical controls. This could mean that either this subgroup of interval cancers does not constitute an excess of rapidly growing tumours, or if it does, that a fast growth rate is not associated with an exceptionally poor prognosis.
该研究描述了参与DOM筛查项目的女性中检测出的75例间期癌（在阴性筛查后2年内发生的癌症）的乳腺癌生存率。在进行乳房X光复查后，该组被分为17例所谓的“漏诊”病例和58例“真正的”间期病例。这58例“真正的”间期病例的十年生存率为58%，与在筛查开始前被诊断为乳腺癌的未筛查女性对照组中检测出的219例癌症的生存率（63%；对数秩检验χ² = 0.98）无显著差异。在校正诊断年龄、肿瘤大小、腋窝状态和诊断年份后，结果基本保持不变。“真正的”间期癌的十年生存率（58%）略低于“漏诊”病例（67%；对数秩检验χ² = 0.38）。这种差异在很大程度上可以由肿瘤大小和腋窝状态的差异来解释。我们得出结论，“真正的”间期癌与未筛查的历史对照组之间的生存率没有重要差异。这可能意味着，要么这个间期癌亚组并不包含过多快速生长的肿瘤，要么即便包含，快速生长率也与异常差的预后无关。
