Evaluation by Markov chain models of a non-randomised breast cancer screening programme in women aged under 50 years in Sweden.
Study objective-To apply Markov chain models that have previously been used on data in randomised trials of breast cancer screening to data from an uncontrolled service screening programme ; to compare results with those from a randomised trial.
Design-A service screening programme in Uppsala county, Sweden, inviting 25 660 women aged 39-49 to mammographic screening every 20 months, and the Swedish Two-County Trial inviting 19 844 women aged 40-49 to two yearly screening, compared with 15 604 women of the same age in an unscreened control group.
Data were analysed using Markov chain models and quasi-likelihood estimation procedures.
Main results-The results with respect to parameters of disease progression were very similar between the two studies.
Use of estimated progression rates to predict the effect on mortality ranged from a 10% to a 17% reduction in breast cancer mortality in the Two-County Study and predicted a 15% reduction in the Uppsala programme.
These compare well with the observed mortality reduction of 13% in the Two-County Trial.
Conclusions-The screening in the Uppsala programme is likely to have a similar effect to that observed in the Two-County Trial.
It is feasible to evaluate non-randomised service screening programmes using Markov chain models.
Mots-clés Pascal : Tumeur maligne, Glande mammaire, Dépistage, Programme sanitaire, Campagne de masse, Diagnostic, Précoce, Mammographie, Mortalité, Evaluation, Efficacité, Homme, Femelle, Age 40-49, Suède, Europe, Glande mammaire pathologie, Radiodiagnostic
Mots-clés Pascal anglais : Malignant tumor, Mammary gland, Medical screening, Sanitary program, Mass campaign, Diagnosis, Early, Mammography, Mortality, Evaluation, Efficiency, Human, Female, Age 40-49, Sweden, Europe, Mammary gland diseases, Radiodiagnosis
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0270530
Code Inist : 002B20E02. Création : 27/11/1998.