Shapiro S
Department of Health Policy, Johns Hopkins University, Baltimore, MD, USA.
J Natl Cancer Inst Monogr. 1997(22):27-30. doi: 10.1093/jncimono/1997.22.27.
This paper summarizes the findings of the first breast cancer screening trial, which was initiated in December 1963 to explore the efficacy of screening. Women aged 40-64 years were selected from enrollees in the Health Insurance Plan (HIP) of Greater New York and were randomly assigned to study and control groups. Study group women were invited for screening, an initial examination, and three annual reexaminations. Screening consisted of film mammography (cephalocaudal and lateral views of each breast) and clinical examination of breasts. Breast cancer and mortality from breast cancer were examined by treatment group (study vs. control) and by entry-age subgroup. By the end of 18 years from entry, the study group had about a 25% lower breast cancer mortality among women aged 40-49 and 50-59 at time of entry than did the control group. However, to a large extent the difference among the 40-49-year-olds occurred in the subgroup with breast cancer diagnosed after these women had passed their 50th birthday, and utility of screening women in their forties is questionable.
本文总结了首次乳腺癌筛查试验的结果，该试验于1963年12月启动，旨在探索筛查的效果。40至64岁的女性从大纽约地区健康保险计划（HIP）的参保人中选取，并被随机分配到研究组和对照组。研究组女性被邀请参加筛查、初次检查以及三次年度复查。筛查包括乳腺钼靶摄影（每个乳房的头尾位和侧位视图）和乳房临床检查。按治疗组（研究组与对照组）以及入组年龄亚组对乳腺癌及乳腺癌死亡率进行了检查。到入组18年结束时，研究组中入组时年龄在40至49岁和50至59岁的女性乳腺癌死亡率比对照组低约25%。然而，在很大程度上，40至49岁女性中的差异出现在这些女性过了50岁生日后被诊断出患有乳腺癌的亚组中，对四十多岁女性进行筛查的效用值得怀疑。
