Detection of ductal carcinoma in situ and subsequent interval cancers.
Detection of ductal carcinoma in situ and subsequent interval cancers.
复制标题
检测导管原位癌和随后的间隔癌。
DOI：
10.1136/bmj.i551
复制
发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Esserman,Laura
中科院分区：
文献类型：
--
作者：
Shieh,Yiwey;Eklund,Martin;Esserman,Laura
Stephen Duffy及其同事最近的报告揭示了导管原位癌（DCIS）检测与随后的间隔癌症发病率之间的关系。1使用英国国家卫生服务乳腺筛查计划（NHSBSP）的数据，作者报告了四年（2003-07）50-69岁女性DCIS的检出率。他们还报告了指数筛查后36个月内的间隔癌症检出率，并检查了检测DCIS对随后间隔癌症率的影响。他们估计，对于DCIS检测率高达1.5每1000名妇女筛选，有一个少浸润性间隔癌在随后的三年中，每三例DCIS.The研究结果支持在英国筛查计划的背景下检测DCIS的好处，其做法是特别翔实，但不同于美国。英国每三年进行一次筛查，而大多数欧洲国家每两年进行一次筛查，美国则每1-2年进行一次筛查。3 4作者通过将单独分析限制在索引筛选的24个月内检测到的间隔癌症来解决这种差异，并发现DCIS和间隔癌症率之间的关系没有差异。此外，英国的质量措施包括双重阅读和要求放射科医生解释乳房X光片阅读至少5000乳房X光片一年。[5]由于对特异性和敏感性的关注，英国的召回率约为美国的一半，阴性活检结果的比率低两倍至三倍。6
The recent report by Stephen Duffy and colleagues sheds light on the relation between the detection of ductal carcinoma in situ (DCIS) and subsequent interval cancer rates. 1 Using data from the UK National Health Service Breast Screening Programme (NHSBSP), the authors report on detection rates of DCIS in women aged 50-69 across four years (2003-07). They also report on interval cancer detection rates in the 36 months after the index screen and examine the effect of detecting DCIS on subsequent interval cancer rates. They estimate that, for DCIS detection rates up to 1.5 per 1000 women screened, there is one fewer invasive interval cancer over the subsequent three years for every three cases of DCIS.The findings support the benefit of detecting DCIS in the context of the UK screening programme, the practices of which are particularly informative but different from those in the United States. Screening in the UK occurs triennially, compared with biennially in most European countries 2 and every 1-2 years in the US. 3 4 The authors addressed this difference by restricting a separate analysis to interval cancers detected within 24 months of the index screen and found no difference in the relation between DCIS and interval cancer rates. In addition, UK quality measures include double reading and a requirement for radiologists interpreting mammograms to read at least 5000 mammograms a year. 5 As a result of the focus on specificity as well as sensitivity, the recall rate in the UK is about half that in the US, and the rate of negative biopsy results is twofold to threefold lower. 6