Optimal breast cancer screening strategies for older women: current perspectives.
Optimal breast cancer screening strategies for older women: current perspectives.
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DOI：
10.2147/cia.s65304
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发表时间：
2016
影响因子：
3.6
通讯作者：
Henderson LM
中科院分区：
文献类型：
--
作者：
Braithwaite D;Demb J;Henderson LM
乳腺癌是65岁或65岁以上老年妇女癌症相关死亡的主要原因。筛查乳房X光检查已被证明在降低50-74岁女性乳腺癌死亡率方面有效，但在75岁或以上女性中无效。鉴于老年女性在共病状态和预期寿命方面存在很大的异质性，在这一人群中筛查乳房X光检查仍然存在争议。随着年龄的增长，预期寿命的缩短可能会减少潜在的筛查好处，并增加损害的风险。在这篇综述中，我们总结了关于筛查乳房X光检查的应用、性能和结果的证据，并强调了证据差距。优化筛查战略将涉及使用有关共病状况和预期寿命的信息，将将从筛查中受益的老年妇女与那些不会受益的老年妇女分开。这项审查确定了与老年妇女乳房X光检查相关的领域，需要进行更多研究，包括需要评估新兴的筛查技术，如老年妇女的断层合成和精确的癌症筛查。在缺乏随机对照试验的情况下，需要使用基于人群的队列数据和模拟模型来评估老年妇女继续筛查乳房X光检查的益处和危害。
Breast cancer is a major cause of cancer-related deaths among older women, aged 65 years or older. Screening mammography has been shown to be effective in reducing breast cancer mortality in women aged 50–74 years but not among those aged 75 years or older. Given the large heterogeneity in comorbidity status and life expectancy among older women, controversy remains over screening mammography in this population. Diminished life expectancy with aging may decrease the potential screening benefit and increase the risk of harms. In this review, we summarize the evidence on screening mammography utilization, performance, and outcomes and highlight evidence gaps. Optimizing the screening strategy will involve separating older women who will benefit from screening from those who will not benefit by using information on comorbidity status and life expectancy. This review has identified areas related to screening mammography in older women that warrant additional research, including the need to evaluate emerging screening technologies, such as tomosynthesis among older women and precision cancer screening. In the absence of randomized controlled trials, the benefits and harms of continued screening mammography in older women need to be estimated using both population-based cohort data and simulation models.
影响因子：
39
作者：
Mandelblatt, Jeanne S.;Tosteson, Anna N. A.;van Ravesteyn, Nicolien T.
通讯作者：
van Ravesteyn, Nicolien T.