V体育安卓版 - Parameter estimates for invasive breast cancer progression in the Canadian National Breast Screening Study
- PMID: 23322203
- PMCID: PMC3593551 (V体育安卓版)
- DOI: 10.1038/bjc.2012.596
V体育安卓版 - Parameter estimates for invasive breast cancer progression in the Canadian National Breast Screening Study
Abstract
Background: The aim of screening is to detect a cancer in the preclinical state. However, a false-positive or a false-negative test result is a real possibility VSports手机版. .
Methods: We describe invasive breast cancer progression in the Canadian National Breast Screening Study and construct progression models with and without covariates. The effect of risk factors on transition intensities and false-negative probability is investigated V体育安卓版. We estimate the transition rates, the sojourn time and sensitivity of diagnostic tests for women aged 40-49 and 50-59. .
Results: Although younger women have a slower transition rate from healthy state to preclinical, their screen-detected tumour becomes evident sooner. Women aged 50-59 have a higher mortality rate compared with younger women. The mean sojourn times for women aged 40-49 and 50-59 are 2. 5 years (95% CI: 1. 7, 3 V体育ios版. 8) and 3. 0 years (95% CI: 2. 1, 4. 3), respectively. Sensitivity of diagnostic procedures for older women is estimated to be 0. 75 (95% CI: 0. 55, 0. 88), while women aged 40-49 have a lower sensitivity (0. 61, 95% CI: 0. 42, 0. 77). Age is the only factor that affects the false-negative probability. For women aged 40-49, 'age at entry', 'history of breast disease' and 'families with breast cancer' are found to be significant for some of the transition rates. For the age-group 50-59, 'age at entry', 'history of breast disease', 'menstruation length' and 'number of live births' are found to affect the transition rates. .
Conclusion: Modelling and estimating the parameters of cancer progression are essential steps towards evaluating the effectiveness of screening policies VSports最新版本. The parameters include the transition rates, the preclinical sojourn time, the sensitivity, and the effect of different risk factors on cancer progression. .
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References
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- Canadian Cancer Society Breast Cancer Statistics at a glance for 2012 Available at http://www.cancer.ca/canada-wide/about%20cancer/cancer%20statistics/stat... Last accessed August 21, 2012
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- Block JP. Compelling Evidence Leads to Change in USPSTF Recommendations on Breast Cancer Screening. J Clin Outcomes Manage. 2010;17 (2:52–55.
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- Chen HH, Duffy SW, Tabar L, Day NE. Markov chain models for progression of breast cancer. Part I: tumour attributes and the preclinical screen-detectable phase. J Epidemiol Biostat. 1997a;2 (1:9–23.
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- Chen HH, Duffy SW, Tabar L, Day NE. Markov chain models for progression of breast cancer. Part II: prediction of outcomes for different screening regimes. J Epidemiol Biostat. 1997b;2 (1:25–35.
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