Breast cancer deaths averted over 3 decades
Breast cancer deaths averted over 3 decades
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DOI：
10.1002/cncr.31954
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发表时间：
2019-05-01
期刊：
影响因子：
6.2
通讯作者：
Helvie, Mark A.
中科院分区：
文献类型：
--
作者：
Hendrick, R. Edward;Baker, Jay A.;Helvie, Mark A.
背景从1975年到1990年，美国女性乳腺癌死亡率每年增加0.4%。自 1990 年以来，乳腺癌死亡率每年下降 1.8% 至 3.4%，这一下降归因于乳房 X 光检查筛查的增加和治疗的改进。方法 作者使用年龄调整后的女性乳腺癌死亡率和来自监测、流行病学和最终结果 (SEER) 计划的人口数据来估计自 1989 年以来通过筛查乳房 X 光检查和改进治疗避免的乳腺癌死亡人数。使用关于背景死亡率的四种不同假设（在没有筛查乳房 X 光检查和改进治疗的情况下），通过 SEER 报告的死亡率与背景之间的差异来估计 40 至 84 岁女性避免的死亡人数每个 5 岁年龄组的死亡率乘以每个 5 岁年龄组的人口。 SEER 数据用于估计 2012 年和 2015 年避免的年度和累计乳腺癌死亡人数，并使用外推 SEER 数据估计 2018 年避免的死亡人数。 结果 2012 年避免的单年乳腺癌死亡人数为 20,860 人至 33,842 人，2015 年为 23,703 人至 39,415 人， 2018 年，乳腺癌死亡率从 27,083 人减少到 45,726 人。2012 年，乳腺癌死亡率下降了 38.6% 到 50.5%，2015 年从 41.5% 下降到 54.2%，2018 年从 45.3% 下降到 58.3%。自 1989 年以来，累计避免的乳腺癌死亡人数为2012 年，从 237,234 人增加到 370,402 人，2015 年从 305,934 人增加到 483,435 人，2018 年从 384,046 人增加到 614,484 人。 结论 自 1989 年以来，通过使用乳房 X 光检查筛查避免了 384,000 至 614,500 例乳腺癌死亡并改善治疗。
Background From 1975 to 1990, female breast cancer mortality rates in the United States increased by 0.4% per year. Since 1990, breast cancer mortality rates have fallen between 1.8% and 3.4% per year, a decrease that is attributed to increased mammography screening and improved treatment. Methods The authors used age-adjusted female breast cancer mortality rate and population data from the Surveillance, Epidemiology, and End Results (SEER) program to estimate the number of breast cancer deaths averted by screening mammography and improved treatment since 1989. Four different assumptions regarding background mortality rates (in the absence of screening mammography and improved treatment) were used to estimate deaths averted for women aged 40 to 84 years by taking the difference between SEER-reported mortality rates and background mortality rates for each 5-year age group, multiplied by the population for each 5-year age group. SEER data were used to estimate annual and cumulative breast cancer deaths averted in 2012 and 2015 and extrapolated SEER data were used to estimate deaths averted in 2018. Results The number of single-year breast cancer deaths averted ranged from 20,860 to 33,842 in 2012, from 23,703 to 39,415 in 2015, and from 27,083 to 45,726 in 2018. Breast cancer mortality reductions ranged from 38.6% to 50.5% in 2012, from 41.5% to 54.2% in 2015, and from 45.3% to 58.3% in 2018. Cumulative breast cancer deaths averted since 1989 ranged from 237,234 to 370,402 in 2012, from 305,934 to 483,435 in 2015, and from 384,046 to 614,484 in 2018. Conclusions Since 1989, between 384,000 and 614,500 breast cancer deaths have been averted through the use of mammography screening and improved treatment.