Assessing the impact of screening mammography: breast cancer incidence and mortality rates in Connecticut (1943-2002)
Assessing the impact of screening mammography: breast cancer incidence and mortality rates in Connecticut (1943-2002)
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DOI：
10.1007/s10549-006-9214-z
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发表时间：
2006-10-01
影响因子：
3.8
通讯作者：
Devesa, Susan S.
中科院分区：
文献类型：
--
作者：
Anderson, William F.;Jatoi, Ismail;Devesa, Susan S.
背景 随机对照研究表明，早期发现和干预可将乳腺癌死亡率降低约 25%。虽然筛查的最终目标是减少乳腺癌死亡，但近期目标是在早期肿瘤对生命构成威胁之前检测和治疗它们。 材料和方法 为了评估早期检测和干预对普通人群的影响，我们分析了 NCI 康涅狄格州历史肿瘤登记处 (1943-2002) 中的乳腺癌发病率和死亡率。 结果 尽管在整个研究期间乳腺癌发病率有所增加，但总体发病率上升速度比以前更快，因为在美国开始进行乳房 X 线摄影筛查。 20世纪80年代初在美国。值得注意的是，早期乳腺癌的分期发病率增加了 152%（每 100,000 名女性年 53.2-133.9 例），而晚期乳腺癌的分期发病率下降了 16%（每 100,000 名女性年 56.1-47.2 例）。在筛查目标女性（40-80 岁）中，早期肿瘤的特定时期和队列年龄发病率急剧上升，而年龄 > 50 岁的女性中，区域和远期肿瘤的发病率略有下降。乳腺癌死亡率下降了 31.6%。 结论 随着早期肿瘤发病率的增加，随着广泛的乳房 X 光检查，晚期疾病的发病率和乳腺癌死亡率有所下降，这与有效的早期检测和随着时间的推移改进治疗相一致。然而，早期肿瘤的急剧上升与晚期疾病和死亡率的适度下降之间的差异表明，许多乳房X光检查衍生的早期病变可能永远不会发展为晚期癌症并对生命构成威胁。
Background Randomized controlled studies demonstrate that early detection and intervention reduce breast cancer mortality by approximately 25%. Though the ultimate goal of screening is to reduce breast cancer deaths, the immediate goal is to detect and treat early-stage tumors before they pose a threat to life.Materials and methods To assess the impact of early detection and intervention in the general population, we analyzed breast cancer incidence and mortality rates in the NCI's Historical Connecticut Tumor Registry (1943-2002).Results Though breast cancer rates increased for the entire study period, overall incidence rates rose faster than previously following, the initiation of mammography screening in the early 1980s in the United States. Of note, stage-specific incidence rates increased 152% (53.2-133.9 per 100,000 woman-years) for early-stage tumors and fell 16% (56.1-47.2 per 100,000 woman-years) for late-stage breast cancers. Period- and cohort-age-specific incidence rates rose dramatically for early-stage tumors among women targeted for screening (ages 40-80 years), whereas rates for regional and distant stages declined modestly among women ages > 50 years. Breast cancer mortality rates fell 31.6%.Conclusions Along with increases in incidence rates for early-stage tumors, rates for late-stage disease and breast cancer mortality declined following widespread screening mammography, consistent with effective early detection and improved treatment over time. However, the disparity between the dramatic rise in early-stage tumors compared to the more modest declines in late-stage disease and mortality suggests that many mammography-derived early-stage lesions may never progress to late-stage cancers and pose a threat to life.