Mammography service screening and mortality in breast cancer patients: 20-year follow-up before and after introduction of screening
Mammography service screening and mortality in breast cancer patients: 20-year follow-up before and after introduction of screening
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DOI：
10.1016/s0140-6736(03)13143-1
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发表时间：
2003-04-26
期刊：
影响因子：
168.9
通讯作者：
Duffy, SW
中科院分区：
文献类型：
--
作者：
Tabar, L;Yen, MF;Duffy, SW
背景乳房x线摄影筛查的长期效果尚不明确。我们的目的是评估乳房x线摄影筛查对乳腺癌死亡的长期影响，考虑到自我选择、乳腺癌发病率变化和死亡原因分类的潜在偏差。方法：我们比较了在引入筛查前20年（1958- 1977）诊断的乳腺癌死亡人数与引入筛查后20年（1978- 1997）诊断的乳腺癌死亡人数，涉及瑞典两个县的21万名年龄在20-69岁的女性。我们还比较了在引入筛查前后20年间被诊断为乳腺癌的所有癌症和所有原因的死亡人数。在分析中，数据被分成受邀接受筛查的年龄组（40-69岁）和未受邀接受筛查的年龄组（20-39岁），以及这些女性是否实际接受了筛查。我们还分别分析了40-49岁年龄组的死亡率。发现40-69岁女性在第二次筛查期乳腺癌未调整死亡风险较第一次筛查期显著下降(相对危险度[RR] 0.77 [95% Cl 0.7-0.85]
Background The long term effect of mammographic service screening is not well established. We aimed to assess the long-term effect of mammographic screening on death from breast cancer, taking into account potential biases from self-selection, changes in breast cancer incidence, and classification of cause of death.Methods We compared deaths from breast cancer diagnosed in the 20 years before screening was introduced (1958-77) with those from breast cancer diagnosed in the 20 years after the introduction of screening (1978-97) in two Swedish counties, in 210 000 women aged 20-69 years. We also compared deaths from all cancers and from all causes in patients diagnosed with breast cancer in the 20 years before and after screening was introduced. In the analysis, data were stratified into age-groups invited for screening (40-69 years) and not invited (20-39 years), and by whether or not the women had actually received screening. We also analysed mortality for the 40-49-year age-group separately.Findings The unadjusted risk of death from breast cancer dropped significantly in the second screening period compared with the first in women aged 40-69 years (relative risk [RR] 0.77 [95% Cl 0.7-0.85]; p