UKCCCR MULTICENTER RANDOMIZED CONTROLLED TRIAL OF ONE AND 2 VIEW MAMMOGRAPHY IN BREAST-CANCER SCREENING
UKCCCR MULTICENTER RANDOMIZED CONTROLLED TRIAL OF ONE AND 2 VIEW MAMMOGRAPHY IN BREAST-CANCER SCREENING
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DOI：
10.1136/bmj.311.7014.1189
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发表时间：
1995-11-04
影响因子：
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通讯作者：
FROST, C
中科院分区：
文献类型：
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作者：
WALD, NJ;MURPHY, P;FROST, C
斜视图（BASED VIEW）-比较一个视图（斜视图）和两个视图（斜位和头尾位）乳房X线摄影在乳腺癌筛查中的应用。设计-随机对照试验。设置-英格兰的九个乳房筛查中心。受试者-40 163名年龄在50-64岁的妇女参加她们的第一次乳房筛查检查。干预-妇女被随机分为单视图乳房X线摄影，双视图乳房X线摄影，或两个视图的乳房X线摄影，其中一个视图由一个读取器读取，两个视图由另一个读取。主要结果测量-检测到的癌症的患病率，回忆率，每个检测到的癌症的成本，结果-双视图乳腺X线摄影比单视图乳腺X线摄影多检出24%的乳腺癌妇女（95%置信区间16%~ 31%）。双视图乳腺X线摄影检出癌症的患病率为6.84/1000，单视图为5.52/1000。接受两个视图（6.97%）乳房X线摄影检查的女性接受评估的比例比接受一个视图（8.16%）乳房X线摄影检查的女性低15%（95%置信区间为6%至23%）。两视图筛查的成本较高（26.46磅，而每次检查为22.00磅），但每次癌症检测的平均费用相似（5330磅与5310磅相比），而用两种观点检测出的每一个额外癌症的边际成本与平均成本相似结论-双视图乳房X线摄影在医学上比单视图更有效;它检测到更多的癌症并降低召回率;它在经济上也具有类似的成本效益。
Objective-To compare one view (oblique) and two view (oblique and craniocaudal) mammography in breast cancer screening.Design-Randomised controlled trial.Setting-Nine breast screening centres in England.Subjects-40 163 women aged 50-64 attending their first breast screening examination.Interventions-Women were randomised to have one view mammography, two view mammography, or two view mammography in which one view was read by one reader and both views were read by another.Main outcome measures-Prevalence of cancer detected, recall rates, cost per cancer detected, and marginal cost per extra cancer detected.Results-Two view mammography detected 24% more women with breast cancer (95% confidence interval 16% to 31%) than one view mammography. Prevalence of detected cancer was 6.84 with two view mammography and 5.52 per 1000 women with one view. The proportion of women recalled for assessment was 15% lower (95% confidence interval 6% to 23%) with two view (6.97%) than with one view (8.16%) mammography. The cost of two view screening was higher (pound 26.46 compared with pound 22.00 per examination) but the average cost per cancer detected was similar (pound 5330 compared with pound 5310) and the marginal cost per extra cancer detected with two views was similar to the average cost (pound 5400).Conclusion-Two view mammography is medically more effective than one view; it detects more cancers and reduces recall rates; it is also similarly cost effective financially.