Clinical Breast Examination: Preliminary Results from a Cluster Randomized Controlled Trial in India

被引:152
作者
Sankaranarayanan, Rengaswamy [1 ]
Ramadas, Kunnambath [2 ]
Thara, Somanathan [3 ]
Muwonge, Richard [1 ]
Prabhakar, Jem [4 ]
Augustine, Paul [4 ]
Venugopal, Muraleedharan [5 ]
Anju, Gopan [2 ]
Mathew, Beela Sara [2 ]
机构
[1] Int Agcy Res Canc, Early Detect & Prevent Sect, Screening Grp, F-69008 Lyon, France
[2] Reg Canc Ctr, Div Radiotherapy, Trivandrum 695011, Kerala, India
[3] Reg Canc Ctr, Div Pathol, Trivandrum 695011, Kerala, India
[4] Reg Canc Ctr, Div Surg Oncol, Trivandrum 695011, Kerala, India
[5] Reg Canc Ctr, Div Imageol, Trivandrum 695011, Kerala, India
来源
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE | 2011年 / 103卷 / 19期
关键词
CANCER INCIDENCE; GLOBAL PATTERNS; MORTALITY; TRENDS;
D O I
10.1093/jnci/djr304
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
A cluster randomized controlled trial was initiated in the Trivandrum district (Kerala, India) on January 1, 2006, to evaluate whether three rounds of triennial clinical breast examination (CBE) can reduce the incidence rate of advanced disease incidence and breast cancer mortality. A total of 275 clusters that included 115 652 healthy women, aged 30-69 years, were randomly allocated to intervention (CBE; 133 clusters; 55 844 women) or control (no screening; 142 clusters; 59 808 women) groups. Performance characteristics (sensitivity, specificity, false-positive rate, and positive predictive value) of CBE were evaluated. An intention-to-treat analysis was performed for comparison of incidence rates between the intervention and control groups. Preliminary results for incidence are based on follow-up until May 31, 2009, when the first round of screening was completed. Of the 50 366 women who underwent CBE, 30 breast cancers were detected among 2880 women with suspicious findings in CBE screening that warranted further investigations. Sensitivity, specificity, false-positive rate, and positive predictive value of CBE were 51.7% (95% confidence interval [CI] = 38.2% to 65.0%), 94.3% (95% CI = 94.1% to 94.5%), 5.7% (95% CI = 5.5% to 5.9%), and 1.0% (95% CI = 0.7% to 1.5%), respectively. The age-standardized incidence rates for early-stage (stage IIA or lower) breast cancer were 18.8 and 8.1 per 100 000 women and for advanced-stage (stage IIB or higher) breast cancer were 19.6 and 21.7 per 100 000 women, in the intervention and control groups, respectively.
引用
收藏
页码:1476 / 1480
页数:5
相关论文
共 31 条
  • [1] Global trends in breast cancer incidence and mortality 1973-1997
    Althuis, MD
    Dozier, JM
    Anderson, WF
    Devesa, SS
    Brinton, LA
    [J]. INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, 2005, 34 (02) : 405 - 412
  • [2] [Anonymous], Breast cancer
  • [3] [Anonymous], BMJ, DOI 10. 1136/ bmj. c1241
  • [4] [Anonymous], 2002, IARC Scientific Publication
  • [5] Advanced breast cancer incidence following population-based mammographic screening
    Autier, P.
    Boniol, M.
    Middleton, R.
    Dore, J. -F.
    Hery, C.
    Zheng, T.
    Gavin, A.
    [J]. ANNALS OF ONCOLOGY, 2011, 22 (08) : 1726 - 1735
  • [6] Disparities in breast cancer mortality trends between 30 European countries: retrospective trend analysis of WHO mortality database
    Autier, Philippe
    Boniol, Mathieu
    LaVecchia, Carlo
    Vatten, Lars
    Gavin, Anna
    Hery, Clarisse
    Heanue, Mary
    [J]. BMJ-BRITISH MEDICAL JOURNAL, 2010, 341 : 335
  • [7] Does this patient have breast cancer? The screening clinical breast examination: Should it be done? How?
    Barton, MB
    Harris, R
    Fletcher, SW
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1999, 282 (13): : 1270 - 1280
  • [8] Blamey RW, 2002, EUR J CANCER, V38, P1458
  • [9] Findings from 752081 clinical breast examinations reported to a national screening program from 1995 through 1998
    Bobo, JK
    Lee, NC
    Thames, SF
    [J]. JOURNAL OF THE NATIONAL CANCER INSTITUTE, 2000, 92 (12) : 971 - 976
  • [10] Cancer mortality in the European Union, 1970-2003, with a joinpoint analysis
    Bosetti, C.
    Bertuccio, P.
    Levi, F.
    Lucchini, F.
    Negri, E.
    La Vecchia, C.
    [J]. ANNALS OF ONCOLOGY, 2008, 19 (04) : 631 - 640