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