Moss S M, Michel M, Patnick J, Johns L, Blanks R, Chamberlain J
Cancer Screening Evaluation Unit, Institute of Cancer Research, Sutton, Surrey, United Kingdom.
J Med Screen. 1995;2(4):186-90. doi: 10.1177/096914139500200403.
To present results from the NHS breast screening programme (NHSBSP) for the three year period 1990 to 1993, and to examine the extent to which interim targets are being met.
Data have been collated from all screening programmes in the United Kingdom on standard "Korner" returns, supplemented for the year 1991/92 by data from the radiology quality assurance programme. Most of the data refer to the prevalent screening round, but some data on rescreening are also available.
The total cancer detection rate at prevalent screens was 6.0/1000, 18% being in situ cancers; the detection rate of invasive cancers < or = 10 mm in diameter was 1.3/1000, but data on size were missing for 12% of cancers. Referral rates were significantly lower for programmes using two view mammography at the prevalent screen than for those using single view, and cancer detection rates were significantly higher. For prevalent screens over the three year period, 70% of programmes had a referral rate of < or = 7%, 87% had a benign biopsy rate of < or = 5/1000, and 79% had a cancer detection rate of > or = 5/1000. By contrast, only 30% of programmes appeared to meet the target detection rate of > 1.5/1000 for invasive cancers < or = 10 mm in diameter.
While the majority of interim targets are being met by the NHSBSP, the rate of detection of small invasive cancers requires careful monitoring. Collection of more accurate data on size of cancers and interval cancer rates will give a better indication of progress towards the target mortality reduction.
展示1990年至1993年三年期间英国国家医疗服务体系乳房筛查计划（NHSBSP）的结果，并考察中期目标的达成程度。
已从英国所有筛查计划中整理出关于标准“科纳”报表的数据，并在1991/92年度补充了放射学质量保证计划的数据。大部分数据涉及初次筛查轮次，但也有一些关于再次筛查的数据。
初次筛查时的总癌症检出率为6.0/1000，其中18%为原位癌；直径小于或等于10毫米的浸润性癌检出率为1.3/1000，但12%的癌症病例缺少大小数据。在初次筛查中使用双视角乳腺钼靶检查的计划转诊率显著低于使用单视角检查的计划，且癌症检出率显著更高。在三年期间进行初次筛查的计划中，70%的计划转诊率小于或等于7%，87%的计划良性活检率小于或等于5/1000，79%的计划癌症检出率大于或等于5/1000。相比之下，只有30%的计划似乎达到了直径小于或等于10毫米的浸润性癌大于1.5/1000的目标检出率。
虽然NHSBSP达到了大部分中期目标，但小浸润性癌的检出率需要仔细监测。收集关于癌症大小和间期癌发病率的更准确数据，将能更好地表明在降低目标死亡率方面的进展情况。
