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50岁以下妇女乳房扫描查的价值50岁以下妇女的乳房扫描查的价值
D M Eddy1, V Hasselblad, W McGivney
1Center for Health Policy Research and Education, Duke University, Durham, NC 27706.
JAMA
|March 11, 1988
概括
40-49岁女性每年进行乳房造影显著减少了26%的乳腺癌死亡率,提供了3.5年的寿命延长. 然而,它增加了成本和虚假阳性和辐射诱导癌症的风险.
科学领域:
- 医学查 医学查
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
背景情况:
- 乳腺癌影响40-49岁的女性,平均风险人群的10年发病率为1.28%,死亡风险为0.82%.
- 目前对这一人口群体的查实践被评估为它们对死亡率和经济结果的影响.
研究的目的:
- 量化评估每年增加乳腺检查的健康和经济后果,为40-49岁的无症状,平均风险的女性每年进行乳腺体检查.
- 估计对乳腺癌死亡率,预期寿命和医疗保健成本的影响.
主要方法:
- 使用了两种定量方法:信任档案和CAN*TROL.
- 分析证据以估计健康结果 (减少死亡率,延长寿命) 和经济后果 (查成本,治疗节省).
主要成果:
- 每年进行乳腺造影,乳腺癌的死亡概率降低了26% (从每万人的8.2到6.0),使受影响妇女的寿命延长了3.5年.
- 查造成的风险为每25000例中1例的辐射诱导癌症和每10例中1例的不必要的手术建议.
- 广泛的查 (25%的40-49岁的美国女性) 可以在2000年预防373例死亡,净成本增加4.02亿美元 (1984美元).
结论:
- 每年进行乳房造影对40-49岁的女性来说,具有显著的死亡率好处,但需要仔细考虑相关的风险和成本.
- 该研究强调了减少死亡率和增加医疗保健支出以及查潜在危害之间的权衡.
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