Breast cancer mortality in Norway after the introduction of mammography screening
Breast cancer mortality in Norway after the introduction of mammography screening
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DOI：
10.1002/ijc.27609
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发表时间：
2013-01-01
影响因子：
6.4
通讯作者：
Lund, Eiliv
中科院分区：
文献类型：
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作者：
Olsen, Anne Helene;Lynge, Elsebeth;Lund, Eiliv
1996年至2004年期间，挪威逐步实施了有组织的乳房x光检查方案。挪威当局已经开始对该计划进行评估。我们的研究重点是乳腺癌死亡率。使用泊松回归，我们比较了四个县在筛查前和筛查期间乳腺癌死亡率的变化，这些县较早开始了该项目，并控制了较晚开始该项目的县在同一时间内乳腺癌死亡率的变化。随访模型包括在随访期间诊断出的所有乳腺癌患者的死亡。评估模型只包括在提供筛查的年龄段诊断出的乳腺癌。研究小组被邀请进行一到三次筛查，平均随访5.9年。在随访模型中，研究组中观察到314例乳腺癌死亡，4个对照组中分别观察到523例、404例和638例。早开始县和晚开始县乳腺癌死亡率变化的比值为0.93（95%可信区间[CI] 0.77-1.12）。在评价模型中，该比值为0.89 （95% CI: 0.71-1.12）。在挪威，有40%的妇女在该项目之前进行了定期乳房x光检查，有组织的乳房x光检查项目的实施与乳腺癌死亡率的下降有关，统计上没有显著意义，下降了约11%。
An organized mammography screening program was gradually implemented in Norway during the period 19962004. Norwegian authorities have initiated an evaluation of the program. Our study focused on breast cancer mortality. Using Poisson regression, we compared the change in breast cancer mortality from before to during screening in four counties starting the program early controlling for change in breast cancer mortality during the same time in counties starting the program late. A follow-up model included death in all breast cancers diagnosed during the follow-up period. An evaluation model included only breast cancers diagnosed in ages where screening was offered. The study group had been invited for screening one to three times and followed for on average of 5.9 years. In the follow-up model, 314 breast cancer deaths were observed in the study group, and 523, 404 and 638, respectively, in the four control groups. The ratio between the changes in breast cancer mortality between early and late starting counties was 0.93 (95% confidence interval [CI] 0.77-1.12). In the evaluation model, this ratio was 0.89 (95% CI: 0.71-1.12). In Norway, where 40% of women used regular mammography prior to the program, the implementation of the organized mammography screening program was associated with a statistically nonsignificant decrease in breast cancer mortality of around 11%.