Attending the breast screening programme after breast cancer treatment: A population-based study
Attending the breast screening programme after breast cancer treatment: A population-based study
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DOI：
10.1016/j.canep.2013.09.003
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发表时间：
2013-12-01
影响因子：
2.6
通讯作者：
Siesling, Sabine
中科院分区：
文献类型：
--
作者：
de Munck, Linda;Kwast, Annemiek;Siesling, Sabine
简介：在荷兰，乳腺癌患者在诊断后至少接受5年的治疗和随访。此外，全国范围的筛查方案每两年邀请50-74岁的所有妇女进行乳房X光检查。门诊随访（治疗后在门诊随访5年）与筛查计划之间的关系尚未明确，认为不希望同时参加筛查计划和门诊随访。本研究评估了影响妇女在门诊随访期间参加筛查计划的潜在因素（重叠）以及在门诊随访5年后参加筛查计划的潜在因素。方法：50-74岁乳腺癌患者数据，1996年至2007年间接受原发性乳腺癌治疗的患者从荷兰癌症登记处选出，并与年国家乳腺癌筛查计划相关联北方地区考克斯回归分析被用来研究妇女（重新）参加筛查计划随着时间的推移，可能的重叠与门诊随访和因素的影响。结果：在总共11 227例乳腺癌患者，其中19%参加了乳腺癌治疗后的筛查计划，4.4%在5年内和15.4%后超过5年。独立影响治疗后5年内以及5年以上就诊的因素有：（HR 0.77; 95% CI 0.61-0.97和HR 0.69; 95% CI 0.53-0.88，参考：筛查检出的肿瘤），接受辅助放疗（HR 0.65; 95% CI 0.47-0.90和HR 0.66; 95% CI 0.47-0.93;参考：无）和原位肿瘤诊断（HR 1.67; 95% CI 1.25-2.23和HR 1.39; 95% CI 1.05-1.85;参考：I期肿瘤）。非屏幕相关的肿瘤（HR 0.41; 95%CI 0.29-0.58）和最近的诊断（HR 0.89每年; 95%CI 0.86-0.92）仅与出勤率在5年内treatment.Conclusion：门诊随访和筛查之间的相互关系应加以改善，以避免重叠和低出勤率的筛查计划门诊随访后。应告知乳腺癌患者，在门诊随访期间参加筛查计划是不必要的。(C)2013爱思唯尔有限公司保留所有权利。
Introduction: In the Netherlands, breast cancer patients are treated and followed at least 5 years after diagnosis. Furthermore, all women aged 50-74 are invited biennially for mammography by the nationwide screening programme. The relation between the outpatient follow-up (follow-up visits in the outpatient clinic for 5 years after treatment) and the screening programme is not well established and attending the screening programme as well as outpatient follow-up is considered undesirable. This study evaluates potential factors influencing women to attend the screening programme during their outpatient follow-up (overlap) and the (re-)attendance to the screening programme after 5 years of outpatient follow-up.Methods: Data of breast cancer patients aged 50-74 years, treated for primary breast cancer between 1996 and 2007 were selected from the Netherlands Cancer Registry and linked to the National Breast Cancer Screening Programme in the Northern region. Cox regression analyses were used to study women (re-) attending the screening programme over time, possible overlap with the outpatient follow-up and factors influencing this.Results: In total 11 227 breast cancer patients were included, of whom 19% attended the screening programme after breast cancer treatment, 4.4% within 5 years and 15.4% after more than 5 years. Factors that independently influenced attendance within 5 years as well as more than 5 years after treatment were: interval tumours (HR 0.77; 95% CI 0.61-0.97 and HR 0.69; 95% CI 0.53-0.88, ref: screen-detected tumours), receiving adjuvant radiotherapy (HR 0.65; 95% CI 0.47-0.90 and HR 0.66; 95% CI 0.47-0.93; ref: none) and diagnosis of in situ tumours (HR 1.67; 95% CI 1.25-2.23 and HR 1.39; 95% CI 1.05-1.85; ref: stage I tumours). Non-screen related tumours (HR 0.41; 95% CI 0.29-0.58) and recent diagnosis (HR 0.89 per year; 95% CI 0.86-0.92) were only associated with attendance within 5 years after treatment.Conclusion: The interrelation between outpatient follow-up and screening should be improved to avoid overlap and low attendance to the screening programme after outpatient follow-up. Breast cancer patients should be informed that attending the screening programme during the outpatient follow-up is not necessary. (C) 2013 Elsevier Ltd. All rights reserved.