Brekelmans C T, Westers P, Faber J A, Peeters P H, Collette H J
Department of Epidemiology, University of Utrecht, Netherlands.
J Epidemiol Community Health. 1996 Feb;50(1):68-71. doi: 10.1136/jech.50.1.68.
To estimate age dependent sensitivity and sojourn time in a breast cancer screening programme by different methods.
The study population comprised women participating in the DOM project--the Utrecht screening programme for the early detection of breast cancer. Breast cancer screening prevalence data and incidence rates after a negative screen were used to estimate age specific sensitivity and mean sojourn time by different methods.
Maximum likelihood estimates of the mean sojourn time varied from one year for women aged 40-49 years to three years for women over the age of 54. Sensitivity was calculated by two different methods. Both pointed to a high sensitivity (around 100%) in the age groups 40-49 and over 55 years. For women aged 50-54, the sensitivity varied from 63% to 100%, depending on the method used and the value of the baseline incidence rate.
Different methods of estimating sensitivity pointed at an acceptable level in women over and under 50 years of age. Sojourn time, and thus the tumour growth rate, seemed to be age dependent. This could mean that the until now disappointing screening results in women under 50 years of age are not so much a result of low sensitivity as of a relatively high tumour growth rate in younger women.
通过不同方法估计乳腺癌筛查项目中年龄依赖性敏感性和停留时间。
研究人群包括参与DOM项目（乌得勒支乳腺癌早期检测筛查项目）的女性。利用乳腺癌筛查患病率数据和阴性筛查后的发病率，通过不同方法估计年龄特异性敏感性和平均停留时间。
平均停留时间的最大似然估计值在40 - 49岁女性中为1年，在54岁以上女性中为3年。敏感性通过两种不同方法计算。两种方法均表明40 - 49岁和55岁以上年龄组的敏感性较高（约100%）。对于50 - 54岁女性，敏感性在63%至100%之间变化，这取决于所使用的方法和基线发病率的值。
不同的敏感性估计方法表明50岁以上和以下女性的敏感性处于可接受水平。停留时间以及肿瘤生长速率似乎与年龄有关。这可能意味着，迄今为止50岁以下女性令人失望的筛查结果，与其说是敏感性低的结果，不如说是年轻女性肿瘤生长速率相对较高的结果。
