A Danish cohort study suggested that breast cancer screening was not associated with a reduction in the incidence of advanced cancer. It is likely that 1 in every 3 invasive tumors and cases of ductal carcinoma in situ (DCIS) diagnosed in women offered screening represent overdiagnosis. The study included women aged 35 to 84 years from 1980 to 2010. Two approaches were used to estimate the amount of overdiagnosis: comparing the incidence of advanced and nonadvanced tumors among women aged 50 to 84 years in screening and nonscreening areas; and comparing the incidence for nonadvanced tumors among women aged 35 to 49, 50 to 69, and 70 to 84 years in screening and nonscreening areas. Screening was not associated with lower incidence of advanced tumors. The incidence of nonadvanced tumors increased in the screening versus prescreening periods (incidence rate ratio, 1.49). The first estimation approach found that 271 invasive breast cancer tumors and 179 DCIS lesions were overdiagnosed in 2010 (overdiagnosis rate of 24.4% [including DCIS] and 14.7% [excluding DCIS]). The second approach, which accounted for regional differences in women younger than the screening age, found that 711 invasive tumors and 180 cases of DCIS were overdiagnosed in 2010 (overdiagnosis rate of 48.3% [including DCIS] and 38.6% [excluding DCIS]. Source: http://annals.org/
丹麦的群组研究表明，乳腺癌筛查与晚期癌症发病率的降低无关。可能在每3个经筛查诊断的浸润性肿瘤和原位导管癌病例中有1例为过度诊断。该研究包括1980年至2010年间35至84岁的女性。使用两种方法来估计过度诊断的数量：比较筛查和非筛查区域50至84岁妇女的晚期和非晚期肿瘤的发生率;并比较35至49岁，50至69岁和70至84岁的妇女在筛查和非筛查区域的非晚期肿瘤发生率。筛查与晚期肿瘤发病率较低无关。筛查期与筛查前期（发生率比，1.49）相比，非晚期期肿瘤的发生率增加。第一种估计方法发现，在2010年过度诊断了271例浸润性乳腺癌和179例原位导管癌病变（过度诊断率为24.4％[包括原位导管癌]和14.7％[不包括原位导管癌]）。第二种方法（包括了小于筛查年龄妇女的区域差异）发现，2010年过度诊断了711例浸润性肿瘤和180例原位导管癌（过度诊断率为48.3％【包括原位导管癌】）和38.6％【不包括原位导管癌】）。 来源：http://annals.org/
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