Overdiagnosis due to breast cancer screening: updated estimates of the Helsinki service study in Finland.
Overdiagnosis due to breast cancer screening: updated estimates of the Helsinki service study in Finland.
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DOI：
10.1038/bjc.2014.413
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发表时间：
2014-09-23
影响因子：
8.8
通讯作者：
Anttila, A.
中科院分区：
文献类型：
--
作者：
Heinavaara, S.;Sarkeala, T.;Anttila, A.
过度诊断是乳腺癌筛查中最重要的不良事件，根据邀请年龄和方法的不同，其估计不良事件从0%到40-50%不等。我们通过比较所有乳腺癌和浸润性乳腺癌的观察和预期累积发病率，更新了芬兰赫尔辛基服务筛查研究中过度诊断的估计。自1986年以来，50-59岁的妇女被邀请参加赫尔辛基服务筛查。在1935-1939年出生的第一批被邀请出生的队列中，乳腺癌的发病率与年龄较大的未被邀请的队列进行了比较。在最后一轮筛选之后，被邀请者的最短随访时间为14年。预期累积发病率用两种方法估计。对于任何乳腺癌和浸润性乳腺癌，过度诊断的估计从5% （95% CI= - 1,11%）到7% （95% CI= 1,13%）不等，取决于入路。我们对过度诊断的估计与欧洲其他合理的估计相同。两种替代方法对预期累积发病率产生了相似的估计，这增加了对过度诊断估计的信心。
Overdiagnosis is the most important adverse event of breast cancer screening with the estimates ranging from 0% to 40–50% depending on invitational age and methods. We updated the estimates of overdiagnosis in Helsinki service screening study in Finland by comparing the observed and expected cumulative incidence of all breast carcinomas and invasive breast carcinomas. Women aged 50–59 years have been invited to Helsinki service screening since 1986. The incidence of breast carcinoma in the first invited birth cohorts born in 1935–1939 was compared with older, non-invited cohorts. The minimum follow-up time of the invitees after the last screening round was 14 years. Expected cumulative incidence rates were estimated with two alternative approaches. For both any breast carcinoma and invasive breast carcinoma, the estimates of overdiagnosis varied from 5% (95% CI=−1, 11%) to 7% (95% CI=1, 13%) depending on the approach. Our estimates of overdiagnosis are of the same magnitude than other plausible estimates in Europe. Both alternative approaches produced similar estimates for the expected cumulative incidence, which increased the confidence in the estimates of overdiagnosis.
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