Effectiveness of clinical breast examination as a 'stand-alone' screening modality: an overview of systematic reviews.
Effectiveness of clinical breast examination as a 'stand-alone' screening modality: an overview of systematic reviews.
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DOI：
10.1186/s12885-020-07521-w
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发表时间：
2020-11-09
期刊：
影响因子：
3.8
通讯作者：
O'Neill C
中科院分区：
文献类型：
--
作者：
Ngan TT;Nguyen NTQ;Van Minh H;Donnelly M;O'Neill C
临床乳腺检查（CBE）的有效性存在不确定性，并且关于其作为乳腺癌筛查工具的有用性的建议相互矛盾。本文概述了评估CBE作为乳腺癌“独立”筛查模式与不筛查相比的有效性的系统评价，并重点关注其在低收入和中等收入国家（LMIC）的价值。我们检索了MEDLINE、EMBASE、Scopus、Web of Science和科克伦系统综述数据库，以查找2019年10月29日之前发表的报告CBE有效性的系统综述。评估的主要结局是死亡率和分期下降。AMSTAR 2检查表用于评估审查的方法学质量，包括偏倚风险。确定了1993年至2019年间发表的11篇系统性综述。没有直接证据表明CBE降低了乳腺癌死亡率。间接证据表明，尽管CBE的灵敏度明显较低（CBE为40-69%，乳腺X线摄影为77-95%），但良好的CBE在死亡率方面与乳腺X线摄影具有相同的效果。在年轻女性和亚洲女性中记录了更大的敏感性。此外，CBE占晚期癌症向早期癌症转变的17%至47%。CBE值得中低收入国家的卫生系统和服务规划者注意，因为在这些国家，基于乳房X光检查的国家筛查方案费用高昂。特别是，在亚洲妇女人数众多和/或年轻妇女面临较高风险的国家开展实施科学研究可能会获得相当大的价值。PROSPERO，注册号CRD 42019126798。在线版本包含补充材料，可通过10.1186/s12885-020-07521-w获得。
There is uncertainty about the effectiveness of clinical breast examination (CBE) and conflicting recommendations regarding its usefulness as a screening tool for breast cancer. This paper provides an overview of systematic reviews that assessed the effectiveness of CBE as a ‘stand-alone’ screening modality for breast cancer compared to no screening and focused on its value in low- and middle-income countries (LMICs). We searched MEDLINE, EMBASE, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews for systematic reviews reporting the effectiveness of CBE published prior to October 29, 2019. The main outcomes assessed were mortality and down staging. The AMSTAR 2 checklist was used to assess the methodological quality of the reviews including risk of bias. Eleven systematic reviews published between 1993 and 2019 were identified. There was no direct evidence that CBE reduced breast cancer mortality. Indirect evidence suggested that a well-performed CBE achieved the same effect as mammography regarding mortality despite its apparently lower sensitivity (40–69% for CBE vs 77–95% for mammography). Greater sensitivity was recorded among younger and Asian women. Moreover, CBE contributed between 17 and 47% of the shift from advanced to early stage cancer. CBE merits attention from health system and service planners in LMICs where a national screening programme based on mammography would be prohibitively expensive. In particular, it is likely that considerable value would be gained from conducting implementation scientific research in countries with large numbers of Asian women and/or where younger women are at higher risk. PROSPERO, registration number CRD42019126798. The online version contains supplementary material available at 10.1186/s12885-020-07521-w.
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DOI：
10.3390/ijerph14040452
发表时间：
2017-04-23
影响因子：
--
作者：
Altobelli E;Rapacchietta L;Angeletti PM;Barbante L;Profeta FV;Fagnano R
通讯作者：
Fagnano R
影响因子：
6.4
作者：
Mandrik, Olena;Zielonke, Nadine;Murillo, Raul
通讯作者：
Murillo, Raul
影响因子：
1.3
作者：
Ginsburg, O. M.
通讯作者：
Ginsburg, O. M.
影响因子：
3.1
作者：
Jatoi, I
通讯作者：
Jatoi, I
影响因子：
3.9
作者：
Boulos, S;Gadallah, M;Miller, AB
通讯作者：
Miller, AB