Effect of screening mammography on breast cancer survival in comparison to other detection methods: A retrospective cohort study
Effect of screening mammography on breast cancer survival in comparison to other detection methods: A retrospective cohort study
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DOI：
10.1111/j.1349-7006.2009.01212.x
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发表时间：
2009-08-01
期刊：
影响因子：
5.7
通讯作者：
Ohuchi, Noriaki
中科院分区：
文献类型：
--
作者：
Kawai, Masaaki;Kuriyama, Shinichi;Ohuchi, Noriaki
在西方国家的随机对照试验中已经确定了筛查性乳腺X射线摄影（SMG）对死亡率的有效性，但在日本尚未确定。本研究通过比较基于检测方法的生存率来评估有效性。采用Kaplan-Meier法估计生存率。使用宫城县癌症登记处确定了1989年1月1日至2000年12月31日诊断的乳腺癌患者，并从诊断日期至死亡日期或随访结束日期（2005年12月31日）进行了随访。采用考克斯比例风险回归模型估计不同检测方法乳腺癌死亡的风险比（HR）和95%可信区间（CI）。7513例患者的平均年龄为55.7岁（范围：15.0-99.3岁）。SMG组、临床乳腺检查（CBE）组和自我检测组的5年生存率分别为98.3%、94.3%和84.8%。与SMG组相比，CBE组患者乳腺癌死亡的HR（95% CI）为2.50（1.10-5.69），自我检测组为6.57（2.94-14.64）。在50-59岁的女性中，CBE组和自我检测组的HR分别为1.64（0.58-4.62）和3.74（1.39-10.03），而在60-69岁的女性中，CBE组和自我检测组的HR分别为2.96（0.68-12.83）和9.51（2.36-38.26）。调整阶段后，HR显著下降。在日本，筛查性乳房X光检查可能对老年人更有效，并能够降低乳腺癌的死亡率。（Cancer Sci 2009）。
The effectiveness of screening mammography (SMG) on mortality has been established in randomized controlled trials in Western countries, but not in Japan. This study evaluated the effectiveness by comparing the survival based on detection methods. The survivals were estimated by the Kaplan-Meier method. Breast cancer patients diagnosed from 1 January 1989 to 31 December 2000 were determined using the Miyagi Prefectural Cancer Registry and follow-up was performed from the date of the diagnosis until the date of death or the end of follow-up, 31 December 2005. The hazard ratios (HR) and 95% confidence interval (CI) of breast cancer death based on the detection methods were estimated by the Cox proportional-hazard regression model. The mean age of the 7513 patients was 55.7 years (range, 15.0-99.3). The 5-year survival associated with the SMG group, the clinical breast examination (CBE) group, and the self-detection group was 98.3%, 94.3%, and 84.8%, respectively. The HR (95% CI) of deaths from breast cancer was 2.50 (1.10-5.69) for patients in the CBE group and 6.57 (2.94-14.64) for the self-detection group in comparison to the SMG group. In women aged 50-59, the HRs were 1.64 (0.58-4.62) among the CBE group and 3.74 (1.39-10.03) among the self-detection group, and the HRs for the CBE and self-detection groups in women aged 60-69 were 2.96 (0.68-12.83) and 9.51 (2.36-38.26), respectively. After adjusting for stage, the HRs dropped remarkably. Screening mammography may be more effective in the elderly group and be able to reduce the mortality of breast cancer in Japan. (Cancer Sci 2009).