| 杜 佳,于智凯,赵胜林,等.2012—2022年重庆市45~74岁女性乳腺癌筛查结果分析[J].中国肿瘤,2025,34(1):43-51. |
| 2012—2022年重庆市45~74岁女性乳腺癌筛查结果分析 |
| Analysis on Screening Results of Breast Cancer Among Women Aged 45~74 in Chongqing from 2012 to 2022 |
| 投稿时间：2024-04-18 |
| DOI：10.11735/j.issn.1004-0242.2025.01.A008 |
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| 中文关键词: 乳腺癌 筛查 高危人群 发病风险 重庆 |
| 英文关键词:breast cancer screening high-risk population breast cancer risk Chongqing |
| 基金项目:重庆市首批公共卫生重点学科（专科）（渝卫办发〔2022〕72号）；2023年度中国消化道早癌医师共同成长计划科研项目（GTCZ-2023-CQ-01） |
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| 中文摘要: |
| 摘 要： ［目的］ 分析2012—2022年重庆市45~74岁女性乳腺癌筛查结果，比较不同特征女性人群乳腺癌发病风险。［方法］ 基于2012—2022年在重庆市城市癌症早诊早治项目，对45~74岁女性居民进行防癌风险评估问卷调查，筛选出乳腺癌高危人群进行临床筛查（乳腺超声联合乳腺X射线检查）。每年对研究人群进行随访，以获得其健康结局信息。计算不同特征女性人群的乳腺癌高危率、筛查依从性、发病密度以及发病风险。［结果］ 该研究共完成防癌风险评估问卷调查207 891人，评估出乳腺癌高危人群35 947人，高危率为17.29%；完成乳腺癌临床筛查14 713人，筛查依从性为40.93%。平均随访（5.43±3.01）年后，确诊乳腺癌847例，累积发病率为407.43/10万，发病密度［95%置信区间（confidence interval，CI）］为75.03/10万（70.15/10万~80.26/10万）人年。Cox比例风险回归结果显示，肥胖者发生乳腺癌的风险较体重正常者有所升高［风险比（hazard ratio，HR）=1.26，95%CI：1.00~1.59］，有乳腺癌家族史者乳腺癌的发病风险较无乳腺癌家族史者明显升高（HR=1.69，95%CI：1.36~2.09）。与乳腺癌风险评估为非高危者相比，高危且参加筛查者和高危未参加筛查者发生乳腺癌的风险均增加（HR=1.36，95%CI：1.06~1.73；HR=1.26，95%CI：1.01~1.56）。［结论］ 对评估出的乳腺癌高危人群开展乳腺超声和乳腺X射线联合筛查，能够提高乳腺癌检出率。未来应努力提高人群筛查依从性，针对发病风险较高的人群开展精准筛查。 |
| 英文摘要: |
| Abstract： ［Purpose］ To analyze the results of breast cancer screening among women aged 45~74 in Chongqing from 2012 to 2022 and compare the risk of breast cancer among women with different characteristics. ［Methods］ The Urban Cancer Early Diagnosis and Treatment Program was conducted in Chongqing from 2012 to 2022， female residents aged 45~74 years old participated in breast cancer screening. The participants who were assessed as at high risk of breast cancer in the preliminary screening were advised to receive ultrasonography and mammography examination in designated hospitals. The study population was followed up annually to obtain information on their health outcomes. The high risk rate of breast cancer， compliance of further examination， the incidence density and breast cancer risk were calculated. ［Results］ A total of 207 891 women completed the questionnaires survey and risk assessment， and 35 947 were assessed as the individuals with high risk of breast cancer with a high risk rate of 17.29%. Among them 14 713 received the imaging screening with a compliance rate of 40.93%. After a mean follow-up of（5.43±3.01） years， 847 cases of breast cancer were diagnosed with a cumulative incidence rate of 407.43/105， an incidence density of 75.03/105 person-years (95%CI： 70.15/105~80.26/105 person-years). Cox proportional hazards regression showed that the risk of breast cancer was higher in obese women than that in normal weight women (HR=1.26， 95%CI： 1.00~1.59); the risk of breast cancer was signifi-cantly higher in those with family history of breast cancer than that in those without family history (HR=1.69， 95%CI： 1.36~2.09). Compared with non-high-risk groups of breast cancer， the risk of breast cancer was increased in high-risk individuals who were screened or not screened (HR=1.36， 95%CI： 1.06~1.73 and HR=1.26， 95%CI： 1.01~1.56). ［Conclusion］ The breast cancer screening program combining primary risk assessment with ultrasonography and mammography for the high-risk groups can improve the detection rate， and the compliance rate of imaging screening need to be improved in the future and make accurate screening for people with high risk of breast cancer. |
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