BMJ:每2年1次的乳腺癌筛查可大幅降低晚期乳腺癌发病率及死亡率

2021-03-02 MedSci原创 MedSci原创

每2年1次的乳腺癌筛查可降低晚期乳腺癌发病率,导致总体乳腺癌死亡率降低了15%,50岁以上患者死亡率显著降低近30%

全世界范围内,乳腺癌的发病率不断上升,在中低收入国家尤其如此,在印度孟买,乳腺癌的发病率在1992年至2016年间上升了近40%。中低收入国家的乳腺癌患者确诊时多处于晚期,占世界乳腺癌死亡的一半以上。
 
乳腺X射线检测是乳腺癌筛查的主要手段,近日研究人员考察了临床乳腺癌筛查对降低乳腺癌分期和疾病死亡率的影响。
本次研究在印度孟买开展,20个地理位置不同的集群参与,随机10个集群进行乳腺癌筛查,10个集群为对照,试验持续时间为20年(1998-2019年)。总计151538名年龄在35-64岁、基线无乳腺癌病史女性参与,筛查组参与者(n=75360)每两年接受总计四轮临床乳腺检查和肿瘤筛查意识培养,然后每两年进行总计五轮积极监测。对照组(n=76178)接受了1次肿瘤筛查意识培养,然后每两年进行总计八轮积极监测。研究的主要终点为乳腺癌诊断阶段和乳腺癌死亡率。
 
筛查组的乳腺癌检出年龄早于对照组(年龄55.18 vs 56.50岁),且患有III或IV期乳腺癌的比例显著降低(37%(n=220)v 47%(n=271))。在整个研究人群中,筛查组与对照组相比,乳腺癌死亡率降低了15%(年龄35-64岁人群:每10万人年死亡20.82例vs24.62例,比率0.85),但亚组分析显示,50岁及以上乳腺癌患者的死亡率降低了近30%(每10万人年死亡24.62例vs 34.68例;HR=0.71),而50岁以下的患者的死亡率变化差异不显著(19.53 vs 21.03;0.93)。筛查组与对照组相比,全因死亡率降低5%,但无统计学意义(比率0.95)。
 
研究认为,每2年1次的乳腺癌筛查可降低晚期乳腺癌发病率,导致总体乳腺癌死亡率降低了15%,50岁以上患者死亡率显著降低近30%
 
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  5. [GetPortalCommentsPageByObjectIdResponse(id=2079291, encodeId=a7de20e929193, content=<a href='/topic/show?id=659ce1280ee' target=_blank style='color:#2F92EE;'>#癌发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71280, encryptionId=659ce1280ee, topicName=癌发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1777154, createdName=chenhongpeng, createdTime=Wed Dec 08 22:33:26 CST 2021, time=2021-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849200, encodeId=4f3a1849200f4, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Thu Jul 08 04:33:26 CST 2021, time=2021-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1799892, encodeId=bb461e99892d5, content=<a href='/topic/show?id=9e3fe127909' target=_blank style='color:#2F92EE;'>#癌发病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71279, encryptionId=9e3fe127909, topicName=癌发病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2c92500045, createdName=12498636m49(暂无昵称), createdTime=Thu Dec 09 00:33:26 CST 2021, time=2021-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1823705, encodeId=217d1823e0532, content=<a href='/topic/show?id=b2873e9220e' target=_blank style='color:#2F92EE;'>#发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Mon Sep 06 21:33:26 CST 2021, time=2021-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=954941, encodeId=bc3c9549412a, content=已看,还可以。, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1bc65476534, createdName=ms6000001015893838, createdTime=Wed Apr 07 16:22:15 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1455984, encodeId=1b26145598418, content=<a href='/topic/show?id=d1fc23e69b7' target=_blank style='color:#2F92EE;'>#乳腺癌筛查#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23769, encryptionId=d1fc23e69b7, topicName=乳腺癌筛查)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=53d75754638, createdName=ay2002fy, createdTime=Thu Mar 04 11:33:26 CST 2021, time=2021-03-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=945212, encodeId=c32c945212a4, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210301/28e81c1eda64491ea0507710c5173138/2e20c197213f4d2bb2c03374b04301e6.jpg, createdBy=bfa51746861, createdName=Angela, createdTime=Wed Mar 03 18:03:58 CST 2021, time=2021-03-03, status=1, ipAttribution=)]
    2021-04-07 ms6000001015893838

    已看,还可以。

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2079291, encodeId=a7de20e929193, content=<a href='/topic/show?id=659ce1280ee' target=_blank style='color:#2F92EE;'>#癌发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71280, encryptionId=659ce1280ee, topicName=癌发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1777154, createdName=chenhongpeng, createdTime=Wed Dec 08 22:33:26 CST 2021, time=2021-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849200, encodeId=4f3a1849200f4, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Thu Jul 08 04:33:26 CST 2021, time=2021-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1799892, encodeId=bb461e99892d5, content=<a href='/topic/show?id=9e3fe127909' target=_blank style='color:#2F92EE;'>#癌发病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71279, encryptionId=9e3fe127909, topicName=癌发病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2c92500045, createdName=12498636m49(暂无昵称), createdTime=Thu Dec 09 00:33:26 CST 2021, time=2021-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1823705, encodeId=217d1823e0532, content=<a href='/topic/show?id=b2873e9220e' target=_blank style='color:#2F92EE;'>#发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Mon Sep 06 21:33:26 CST 2021, time=2021-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=954941, encodeId=bc3c9549412a, content=已看,还可以。, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1bc65476534, createdName=ms6000001015893838, createdTime=Wed Apr 07 16:22:15 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1455984, encodeId=1b26145598418, content=<a href='/topic/show?id=d1fc23e69b7' target=_blank style='color:#2F92EE;'>#乳腺癌筛查#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23769, encryptionId=d1fc23e69b7, topicName=乳腺癌筛查)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=53d75754638, createdName=ay2002fy, createdTime=Thu Mar 04 11:33:26 CST 2021, time=2021-03-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=945212, encodeId=c32c945212a4, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210301/28e81c1eda64491ea0507710c5173138/2e20c197213f4d2bb2c03374b04301e6.jpg, createdBy=bfa51746861, createdName=Angela, createdTime=Wed Mar 03 18:03:58 CST 2021, time=2021-03-03, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=2079291, encodeId=a7de20e929193, content=<a href='/topic/show?id=659ce1280ee' target=_blank style='color:#2F92EE;'>#癌发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71280, encryptionId=659ce1280ee, topicName=癌发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1777154, createdName=chenhongpeng, createdTime=Wed Dec 08 22:33:26 CST 2021, time=2021-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849200, encodeId=4f3a1849200f4, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Thu Jul 08 04:33:26 CST 2021, time=2021-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1799892, encodeId=bb461e99892d5, content=<a href='/topic/show?id=9e3fe127909' target=_blank style='color:#2F92EE;'>#癌发病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71279, encryptionId=9e3fe127909, topicName=癌发病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2c92500045, createdName=12498636m49(暂无昵称), createdTime=Thu Dec 09 00:33:26 CST 2021, time=2021-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1823705, encodeId=217d1823e0532, content=<a href='/topic/show?id=b2873e9220e' target=_blank style='color:#2F92EE;'>#发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Mon Sep 06 21:33:26 CST 2021, time=2021-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=954941, encodeId=bc3c9549412a, content=已看,还可以。, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1bc65476534, createdName=ms6000001015893838, createdTime=Wed Apr 07 16:22:15 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1455984, encodeId=1b26145598418, content=<a href='/topic/show?id=d1fc23e69b7' target=_blank style='color:#2F92EE;'>#乳腺癌筛查#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23769, encryptionId=d1fc23e69b7, topicName=乳腺癌筛查)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=53d75754638, createdName=ay2002fy, createdTime=Thu Mar 04 11:33:26 CST 2021, time=2021-03-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=945212, encodeId=c32c945212a4, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210301/28e81c1eda64491ea0507710c5173138/2e20c197213f4d2bb2c03374b04301e6.jpg, createdBy=bfa51746861, createdName=Angela, createdTime=Wed Mar 03 18:03:58 CST 2021, time=2021-03-03, status=1, ipAttribution=)]
    2021-03-03 Angela

    学习了

    0

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