合作建模以比较不同乳腺癌查策略:美国预防服务工作组的决策分析
Amy Trentham-Dietz1, Christina Hunter Chapman2, Jinani Jayasekera3
1Department of Population Health Sciences and Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison.
JAMA
|April 30, 2024
概括
每两年从40岁开始进行一次乳腺癌查, 显著减少乳腺癌死亡率, 针对高风险妇女的查可以维持好处并减少差异.
科学领域:
- 癌症学
- 放射学
- 公共卫生
背景情况:
- 乳腺癌查的有效性受发病率变化和治疗进展的影响.
- 最佳的乳房扫描查策略需要更新的结果估计.
研究的目的:
- 估计美国妇女各种乳房扫描查策略的终身结果.
- 为了比较数字乳房扫描和数字乳房断层合成 (DBT) 查间隔和年龄.
主要方法:
- 使用了6个癌症干预和监测建模网络 (CISNET) 模型与国家数据.
- 评估了36种查策略 (年龄在40-79岁之间,年/两年间隔),使用数字乳房影像或DBT.
- 对所有妇女,特别是黑人妇女的评估结果,假设100%的遵守.
主要成果:
- 从40岁到74岁进行两年一次的DBT查,每1000名女性中避免了8.2例死亡,而没有查,使死亡率降低了30%.
- 数字性乳房扫描也产生了类似的好处, 但更多的假阳性; 年度查增加了好处, 但也增加了危害.
- 持续查至79岁时,发现效益与危害的比率相似或更高. 风险较高的女性获得更大的好处.
结论:
- 每两年进行一次乳房扫描, 特别是从40岁开始, 有效地减少乳腺癌死亡率, 增加寿命.
- 加强对高风险个体的查可以保持益处与危害的比率并减少死亡率差异.
- 针对40岁以上的黑人妇女进行年度查,然后每两年进行一次查,可以缓解死亡率差距.
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