The age-specific sensitivity of a screening program was investigated using a population-based cancer registry as a source of false-negative cancer cases. A population-based screening program for breast cancer was run using either clinical breast examinations (CBE) alone or mammography combined with CBE in the Miyagi Prefecture from 1997 to 2002. Interval cancers were newly identified by linking the screening records to the population-based cancer registry to estimate the number of false-negative cases of screening program. Among 112 071 women screened by mammography combined with CBE, the number of detected cancers, false-negative cases and the sensitivity were 289, 22 and 92.9%, respectively, based on the reports from participating municipalities. The number of newly found false-negative cases and corrected sensitivity when using the registry were 34 and 83.8%, respectively. In detected cancers, the sensitivity of screening by mammography combined with CBE in women ranging from 40 to 49 years of age based on a population-based cancer registry was much lower than that in women 50-59 and 60-69 years of age (40-49: 18, 71.4%, 50-59: 19, 85.8%, 60-69: 19, 87.2%). These data suggest that the accurate outcome of an evaluation of breast cancer screening must include the use of a population-based cancer registry for detecting false-negative cases. Screening by mammography combined with CBE may therefore not be sufficiently sensitive for women ranging from 40 to 49 years of age.

译文

使用基于人群的癌症注册表作为假阴性癌症病例的来源,研究了筛查计划的年龄特异性敏感性。在宫城县1997年2002年,仅使用临床乳房检查 (CBE) 或乳房x线摄影结合CBE进行了基于人群的乳腺癌筛查计划。通过将筛查记录与基于人群的癌症登记处联系起来,以估计筛查计划的假阴性病例数,新发现了间隔性癌症。根据参与城市的报告,在112 071名乳房x线摄影联合CBE筛查的妇女中,检测到的癌症、假阴性病例和敏感性分别为289、22和92.9%。使用注册表时,新发现的假阴性病例数和纠正的敏感性分别为34和83.8%。在检测到的癌症中,根据基于人群的癌症登记,在40至49岁的女性中通过乳房x线摄影联合CBE进行筛查的敏感性远低于50-59岁和60-69岁的女性 (40-49: 18,71.4%,50-59: 19,85.8%,60-69: 19,87.2%)。这些数据表明,乳腺癌筛查评估的准确结果必须包括使用基于人群的癌症注册表来检测假阴性病例。因此,对于40至49岁的女性,乳房x线摄影联合CBE筛查可能不够敏感。

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