Mammography screening reduces rates of advanced and fatal breast cancers: Results in 549,091 women
Mammography screening reduces rates of advanced and fatal breast cancers: Results in 549,091 women
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DOI：
10.1002/cncr.32859
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发表时间：
2020-05-11
期刊：
影响因子：
6.2
通讯作者：
Chen, Tony Hsiu-Hsi
中科院分区：
文献类型：
--
作者：
Duffy, Stephen W.;Tabar, Laszlo;Chen, Tony Hsiu-Hsi
背景：评估参与有组织的乳腺X线摄影服务筛查的影响是至关重要的，独立于乳腺癌治疗的变化。这可以通过测量致命性乳腺癌的发病率来实现，这是基于诊断日期而不是死亡日期。作者计算了2473例确诊后10年内死亡的乳腺癌的发病率和9737例晚期乳腺癌的发病率，乳腺癌从瑞典国家登记处收集了关于每个乳腺癌诊断和每个乳腺癌病例的死亡原因和日期的数据。从区域癌症中心收集肿瘤特征。关于邀请和参与的汇总数据由Sectra Medical Systems AB提供。采用Poisson回归分析发病率。结果参加乳腺X线筛查的妇女在10年内死于乳腺癌的风险降低了41%，具有统计学意义（相对危险度，0.59; 95%CI，0.51-0.68 [P < .001]），晚期乳腺癌发生率降低25（相对危险度，0.75; 95%CI，0.66-0.84 [P <0.001]）。结论在同期比较中发现，参与筛查的妇女与未参与筛查的妇女相比，诊断后10年内致命的乳腺癌发病率和晚期乳腺癌发病率显著降低。这些益处似乎与最近治疗方案的变化无关。
Background It is of paramount importance to evaluate the impact of participation in organized mammography service screening independently from changes in breast cancer treatment. This can be done by measuring the incidence of fatal breast cancer, which is based on the date of diagnosis and not on the date of death.Methods Among 549,091 women, covering approximately 30% of the Swedish screening-eligible population, the authors calculated the incidence rates of 2473 breast cancers that were fatal within 10 years after diagnosis and the incidence rates of 9737 advanced breast cancers. Data regarding each breast cancer diagnosis and the cause and date of death of each breast cancer case were gathered from national Swedish registries. Tumor characteristics were collected from regional cancer centers. Aggregated data concerning invitation and participation were provided by Sectra Medical Systems AB. Incidence rates were analyzed using Poisson regression.Results Women who participated in mammography screening had a statistically significant 41% reduction in their risk of dying of breast cancer within 10 years (relative risk, 0.59; 95% CI, 0.51-0.68 [P < .001]) and a 25% reduction in the rate of advanced breast cancers (relative risk, 0.75; 95% CI, 0.66-0.84 [P < .001]).Conclusions Substantial reductions in the incidence rate of breast cancers that were fatal within 10 years after diagnosis and in the advanced breast cancer rate were found in this contemporaneous comparison of women participating versus those not participating in screening. These benefits appeared to be independent of recent changes in treatment regimens.