Shapiro S, Coleman E A, Broeders M, Codd M, de Koning H, Fracheboud J, Moss S, Paci E, Stachenko S, Ballard-Barbash R
Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD, USA.
Int J Epidemiol. 1998 Oct;27(5):735-42. doi: 10.1093/ije/27.5.735.
Currently there are at least 22 countries worldwide where national, regional or pilot population-based breast cancer screening programmes have been established. A collaborative effort has been undertaken by the International Breast Cancer Screening Network (IBSN), an international voluntary collaborative effort administered from the National Cancer Institute in the US for the purposes of producing international data on the policies, funding and administration, and results of population-based breast cancer screening.
Two surveys conducted by the IBSN in 1990 and 1995 describe the status of population-based breast cancer screening in countries which had or planned to establish breast cancer screening programmes in their countries. The 1990 survey was sent to ten countries in the IBSN and was completed by nine countries. The 1995 survey was sent to and completed by the 13 countries in the organization at that time and an additional nine countries in the European Network.
The programmes vary in how they have been organized and have changed from 1990 to 1995. The most notable change is the increase in the number of countries that have established or plan to establish organized breast cancer screening programmes. A second major change is in guidelines for the lower age limit for mammography screening and the use of the clinical breast examination and breast self-examination as additional detection methods.
As high quality population-based breast cancer screening programmes are implemented in more countries, they will offer an unprecedented opportunity to assess the level of coverage of the population for initial and repeat screening, evaluation of performance, and, in the longer term, outcome of screening in terms of reduction in the incidence of late-stage disease and in mortality.
目前,全球至少有22个国家已建立了全国性、地区性或试点性的基于人群的乳腺癌筛查项目。国际乳腺癌筛查网络(IBSN)开展了一项合作努力,这是一项由美国国立癌症研究所管理的国际自愿合作项目,旨在收集有关基于人群的乳腺癌筛查政策、资金、管理及结果的国际数据。
IBSN在1990年和1995年进行了两项调查,描述了那些已在本国开展或计划开展乳腺癌筛查项目的国家中基于人群的乳腺癌筛查状况。1990年的调查发送给了IBSN的10个国家,9个国家完成了调查。1995年的调查发送给了当时该组织的13个国家以及欧洲网络的另外9个国家,并由这些国家完成。
这些项目在组织方式上各不相同,且从1990年到1995年有所变化。最显著的变化是已建立或计划建立有组织的乳腺癌筛查项目的国家数量增加。第二个主要变化在于乳腺钼靶筛查的较低年龄限制指南,以及将临床乳腺检查和乳腺自我检查作为额外检测方法的使用。
随着越来越多的国家实施高质量的基于人群的乳腺癌筛查项目,它们将提供前所未有的机会来评估人群初次和重复筛查的覆盖水平、性能评估,以及从长期来看,筛查在降低晚期疾病发病率和死亡率方面的效果。