根据检测方式在德国对乳腺癌存活率的时校正效应
Laura Schumann1, Moritz Hadwiger1, Nora Eisemann1
1Institute of Social Medicine and Epidemiology, University of Luebeck, 23562 Luebeck, Germany.
Cancers
|April 13, 2024
概括
屏幕检测到的乳腺癌 (BC) 显示了更好的生存率,但领先时间偏差是一个因素. 经过调整后,查检测到的BC仍然有10-27%的更好的生存率,可能是由于查质量.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 生物统计学 生物统计学
背景情况:
- 查检测到的乳腺癌 (BC) 通常比症状BC的生存率更好.
- 在查检测的BC中,改善的生存率主要与早期阶段的检测有关.
- 领先时间偏差,通过查推进诊断,可以膨胀生存估计.
研究的目的:
- 调查是否存在查检测和症状性乳腺癌之间的存活率差异,在考虑领先时间偏差后.
- 探索查质量对生存结果的潜在贡献.
主要方法:
- 从德国基于人口的癌症登记处分析了2000年至2022年期间被诊断患有BC的32,169名妇女.
- 使用Kaplan-Meier和Cox回归模型比较生存率,根据年龄,分级和UICC阶段进行调整.
- 使用已建立和最近公布的逗留时间估计进行了领先时间偏差的校正.
主要成果:
- 未经调整的分析显示,症状性BC的存活率显著降低 (HR:0.23).
- 在对预后因素和领先时间偏差进行调整后,屏幕检测到的BC存活率是10-27%更好 (HR:0.73-0.84).
- 这些结果与其他国家乳腺癌查计划的发现一致.
结论:
- 屏幕检测和症状BC之间的初始生存差异在很大程度上受到领先时间偏差的影响.
- 查检测到的BC的剩余生存益处在统计调整后仍然存在,这表明查的潜在积极影响.
- 需要进一步的研究来排除其他混因素,如自我选择偏见.
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