Reduced breast cancer mortality in women under age 50: updated results from the Malmö Mammographic Screening Program.
Reduced breast cancer mortality in women under age 50: updated results from the Malmö Mammographic Screening Program.
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降低 50 岁以下女性乳腺癌死亡率：马尔默乳腺 X 光检查计划的最新结果。
DOI：
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发表时间：
1997
期刊：
影响因子：
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通讯作者：
L. Janzon
中科院分区：
文献类型：
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作者：
I. Andersson;L. Janzon
本文提供了来自马尔默乳腺X线筛查试验（MMST）的两个队列的额外随访数据。第一个队列，MMST I，包含7，984名年龄在50岁以下的妇女，她们在1927年至1932年之间出生。其中一半被分配到一个对照组，直到1988年MMST破译密码后的四年才被邀请参加检查。第二个队列，MMST II，包含1933年至1945年出生的17，786名女性。这些妇女中有54%在1978年至1990年间被随机邀请进行筛查。剩下的46%，即对照组，在1991年至1994年期间被邀请进行筛查。在MMST I中完成了9轮筛选，在MMST II中平均完成了5轮筛选;筛选间隔范围为18至24个月。通过合并两个队列来评估筛查对乳腺癌死亡率的影响。在随访结束时-1993年12月MMST I和1995年12月MMST II-干预组乳腺癌死亡率在统计学上显著降低36%（相对危险度= 0.64; 95%CI：0.45-0.89; P = 0.009）。然而，一项危害-效益分析表明，每预防两例乳腺癌死亡，就诊断出一例临床上不重要的癌症;每预防一例乳腺癌死亡，就有63名无癌妇女被召回接受进一步检查;每挽救20个生命，就可能发生一例辐射引起的乳腺癌死亡。因此，筛查的建议必须权衡死亡率的好处与这些负面影响。
This article provides additional follow-up data of two cohorts from the Malmö Mammographic Screening Trial (MMST). The first cohort, MMST I, contained 7,984 women under age 50 at entry into MMST who were born between 1927 and 1932. Half were assigned to a control group and were not invited for examination until four years after the code was broken in the MMST in 1988. The second cohort, MMST II, contained 17,786 women born between 1933 and 1945. Fifty four percent of these women were randomly invited to screening between 1978 and 1990. The remaining 46%--the control group--was invited to screening between 1991 and 1994. Nine screening rounds were completed in MMST I, and a mean of five rounds were completed in MMST II; the screening interval ranged from 18 to 24 months. The effect of screening on breast cancer mortality was assessed by pooling the two cohorts. At the end of follow-up--December 1993 for MMST I and December 1995 for MMST II--there was a statistically significant 36% reduction in breast cancer mortality in the intervention groups (relative risk = 0.64; 95% CI: 0.45-0.89; P = 0.009). A harm-benefit analysis showed, however, that for every two breast cancer deaths prevented, one clinically insignificant cancer was diagnosed; for each breast cancer death prevented, 63 cancer-free women had been called back for further examinations; and for every 20 lives saved, one radiation-induced breast cancer death may have occurred. Recommendations for screening must therefore weigh mortality benefits against these negative effects.