Elovainio L, Nieminen P, Miller A B
Cancer Society of Finland, Helsinki, Finland.
Int J Gynaecol Obstet. 1997 Jul;58(1):137-47. doi: 10.1016/s0020-7292(97)02859-2.
Worldwide, 31% of cancers in women are in the breast or uterine cervix. Prevention of cervical cancer is effective with the use of the cervical Pap smear test if applied in an organized and continuous fashion, including treatment of precancerous lesions. At best such programs have led to a 60% decrease in cervical cancer incidence and mortality in the Nordic countries. Early detection of breast cancer in a population based screening may lead to a 30% reduction of mortality from this disease in the screened population. Measures to guarantee high coverage and attendance, adequate field facilities, organized program for quality control and adequate facilities for diagnosis and treatment are prerequisites of successful programs. In absolute terms the contribution of screening to the total mortality reduction among middle-aged populations is small, much smaller than the potential gains from cancer prevention.
在全球范围内,女性所患癌症中有31%发生在乳腺或子宫颈。如果以有组织且持续的方式应用子宫颈巴氏涂片检查,包括对癌前病变进行治疗,那么预防子宫颈癌是有效的。这类项目在北欧国家至多使子宫颈癌发病率和死亡率降低了60%。在基于人群的筛查中早期发现乳腺癌,可能会使筛查人群中该疾病的死亡率降低30%。确保高覆盖率和参与率、充足的现场设施、有组织的质量控制项目以及足够的诊断和治疗设施,是成功项目的先决条件。从绝对数值来看,筛查对中年人群总体死亡率降低的贡献较小,远小于癌症预防可能带来的收益。