THE EDINBURGH RANDOMIZED TRIAL OF BREAST-CANCER SCREENING - RESULTS AFTER 10 YEARS OF FOLLOW-UP

被引:94
作者
ALEXANDER, FE
ANDERSON, TJ
BROWN, HK
FORREST, APM
HEPBURN, W
KIRKPATRICK, AE
MCDONALD, C
MUIR, BB
PRESCOTT, RJ
SHEPHERD, SM
SMITH, A
WARNER, J
机构
[1] UNIV EDINBURGH,SCH MED,DEPT PATHOL,EDINBURGH EH8 9AG,MIDLOTHIAN,SCOTLAND
[2] UNIV EDINBURGH,SCH MED,SCOTTISH CANC TRIALS OFF,EDINBURGH EH8 9AG,MIDLOTHIAN,SCOTLAND
[3] EDINBURGH BREAST SCREENING CLIN,EDINBURGH EH11 2JL,MIDLOTHIAN,SCOTLAND
[4] SCOTTISH HLTH SERV,COMMON SERV AGCY,DIV INFORMAT & STAT,EDINBURGH EH5 3SQ,MIDLOTHIAN,SCOTLAND
关键词
D O I
10.1038/bjc.1994.342
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The Edinburgh Randomised Trial of Breast Cancer Screening recruited 44,288 women aged 45-64 years into the initial cohort of the trial during 1978-81, and 10 years of follow-up is now complete. A total of 22,944 women were randomised into the study group and were offered screening for 7 years; the remaining women formed the control group. After 10 years, breast cancer mortality is 14-21% lower in the study group than in the controls depending on the precise definition of the end point. These differences are not statistically significant; for breast cancer as the underlying cause of death the relative risk is 0.82 (95% confidence interval 0.61-1.11). Rates of locally advanced and metastatic cancer were substantially lower in the study group, but screening has failed to achieve marked reductions in rates of small node-positive cancers. Those women who accepted the final invitation to screening have been monitored over the 3 year period prior to their first screen under the UK service screening programme. Interval cases, expressed as a proportion of the control incidence, increased from 12% in the first year to 67% in the third year. The reduction in breast cancer mortality for older women (aged at least 50 years) is the same as that for the total study group for this duration of follow-up. For analyses of breast cancer mortality in younger women updates recruited to the trial from 1982 to 1985 (10,383 women with 6-8 years' follow-up) have been included. The reduction in breast cancer mortality for women aged 45-49 years at entry was 22% (relative risk = 0.78, 95% confidence interval = 0.46-1.31).
引用
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页码:542 / 548
页数:7
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