Absolute numbers of lives saved and overdiagnosis in breast cancer screening, from a randomized trial and from the Breast Screening Programme in England.
Absolute numbers of lives saved and overdiagnosis in breast cancer screening, from a randomized trial and from the Breast Screening Programme in England.
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DOI：
10.1258/jms.2009.009094
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发表时间：
2010
影响因子：
2.9
通讯作者：
Smith RA
中科院分区：
文献类型：
--
作者：
Duffy SW;Tabar L;Olsen AH;Vitak B;Allgood PC;Chen TH;Yen AM;Smith RA
估计50-69岁乳房X光检查中预防的乳腺癌死亡绝对数和被误诊的肿瘤绝对数。瑞典两县乳房X光检查乳腺癌随机试验和英国乳房筛查计划，年龄在50-69岁之间。我们通过与对照组(被动研究人群)的比较，估计了瑞典两县试验的研究组(主动研究人群)避免的死亡和额外诊断的病例的绝对数量。我们对英格兰(分别为1974-2004年和1974-2003年)的死亡率和发病率进行了相同的估计。我们使用泊松回归进行统计推断。乳腺癌死亡率的显著降低与两县试验(P<；0.001)和英格兰筛查计划(P<；0.001)的筛查有关。据估计，在英格兰的两县试验和筛查计划中，从50岁开始，每1000名女性在20年内进行筛查，乳腺癌死亡的绝对益处分别为8.8和5.7。20年来，每1000名接受筛查的妇女中相应估计的过度诊断病例数分别为4.3例和2.3例。就绝对值而言，乳房X光检查在挽救生命方面的好处大于在过度诊断方面的危害。每一个过度诊断的病例就挽救了2到2.5人的生命。
To estimate the absolute numbers of breast cancer deaths prevented and the absolute numbers of tumours overdiagnosed in mammographic screening for breast cancer at ages 50–69 years. The Swedish Two-County randomized trial of mammographic screening for breast cancer, and the UK Breast Screening Programme in England, ages 50–69 years. We estimated the absolute numbers of deaths avoided and additional cases diagnosed in the study group (active study population) of the Swedish Two-County Trial, by comparison with the control group (passive study population). We estimated the same quantities for the mortality and incidence rates in England (1974–2004 and 1974–2003, respectively). We used Poisson regression for statistical inference. A substantial and significant reduction in breast cancer mortality was associated with screening in both the Two-County Trial (P < 0.001) and the screening programme in England (P < 0.001). The absolute benefits were estimated as 8.8 and 5.7 breast cancer deaths prevented per 1000 women screened for 20 years starting at age 50 from the Two-County Trial and screening programme in England, respectively. The corresponding estimated numbers of cases overdiagnosed per 1000 women screened for 20 years were, respectively, 4.3 and 2.3 per 1000. The benefit of mammographic screening in terms of lives saved is greater in absolute terms than the harm in terms of overdiagnosis. Between 2 and 2.5 lives are saved for every overdiagnosed case.
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影响因子：
2.1
作者：
Hogben, Rosalyn Katy F.
通讯作者：
Hogben, Rosalyn Katy F.
影响因子：
2.9
作者：
Duffy, SW
通讯作者：
Duffy, SW
影响因子：
--
作者：
Zackrisson, S;Andersson, I;Garne, JP
通讯作者：
Garne, JP
影响因子：
1.9
作者：
Smith, RA;Duffy, SW;Chen, THH
通讯作者：
Chen, THH
DOI：
10.7326/0003-4819-137-5_part_1-200209030-00012
发表时间：
2002-09-03
影响因子：
39.2
作者：
Humphrey, LL;Helfand, M;Woolf, SH
通讯作者：
Woolf, SH