| Titre : | Evaluation by Markov chain models of a non-randomised breast cancer screening programme in women aged under 50 years in Sweden. (1998) |
| Auteurs : | H.H. CHEN ; S.W. DUFFY ; L. TABAR ; E. THURFJELL |
| Type de document : | Article |
| Dans : | Journal of epidemiology and community health (vol. 52, n° 5, 1998) |
| Pagination : | 329-335 |
| Langues: | Anglais |
| Mots-clés : | Cancer ; Sein ; Dépistage ; Programme santé ; Diagnostic ; Mammographie ; Létalité ; Evaluation ; Efficacité ; Homme ; Femme ; Suède ; Europe ; Glande mammaire [pathologie] ; Radiodiagnostic |
| Résumé : | [BDSP. Notice produite par INIST YR0xO5Xw. Diffusion soumise à autorisation]. 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. |
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