Abstract:
STUDY OBJECTIVE:To assess the performance of breast cancer screening in different age categories over two decades. DESIGN:Important determinants of reduced breast cancer mortality such as attendance, mammography performance, cancer detection, and disease stage were recorded. SETTING:Nijmegen, The Netherlands, 1975-92. SUBJECTS:Since 1975 more than 40,000 women aged 35 years and older have been invited biennially for breast screening in a population based project in Nijmegen. MAIN RESULTS:Rates of attendance, referral, detection, and disease stage were calculated, as well as the specificity of screening mammography and the predictive value of referral and biopsy. From round 3 onwards, the attendance rate of women younger than 50 years stabilised at 70%, in women of 50-69 years it was 62%, and in women aged 70 and over it was 22%. In these three age categories, the referral rates of a positive screening mammography per 1000 screened women were 4.9, 6.2, and 11.8, respectively. Specificity rates were between 99% and 100%. Current predictive values of referral were high: in the specific age categories 39%, 59%, and 68% of the referred women had cancer. Detection rates remained fairly stable over the rounds 4-9, at 1.9, 3.6, and 8.0 cancers per 1000 screened women. In the two year period between screening the numbers of interval cancers per 1000 screened women were 2.2, 2.2, and 2.9, for the three age categories respectively. With regard to invasive cancers detected during screening, the percentage of small tumours (< or = 20 mm on the mammogram) was 84% in each age category. For women younger than 50 years, the proportion of intraductal carcinoma in all the cancers detected at screening was 40%, while it was 15% in the other age categories. CONCLUSION:Throughout the nine rounds, the screening outcomes were found to be adequate, particularly considering the high specificity rate and the predictive value of referral without the interference of a low detection rate. Although the occurrence of interval cancers seemed high, it was similar to other screening programmes. Despite a relatively low referral rate, the ratios of screen detected versus interval cancer cases were favourable. Well organised screening programmes can achieve good mammography results without too many false positives. It is important that women continue to participate in a screening programme because cancer can still be detected even after several successive negative screening examinations.
journal_name
J Epidemiol Community Healthjournal_title
Journal of epidemiology and community healthauthors
Otten JD,van Dijck JA,Peer PG,Straatman H,Verbeek AL,Mravunac M,Hendriks JH,Holland Rdoi
10.1136/jech.50.3.353subject
Has Abstractpub_date
1996-06-01 00:00:00pages
353-8issue
3eissn
0143-005Xissn
1470-2738journal_volume
50pub_type
杂志文章abstract:BACKGROUND:Although a known risk factor for several respiratory diseases, the relationship between cooking smoke and tuberculosis has not been conclusively established. Hence, a case-control study was conducted among adult women of Chandigarh Union Territory in India. METHODS:Physician-diagnosed cases of sputum positi...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2010.115840
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:High intelligence early in life has consistently been associated with decreased mortality, but the mechanisms are still not fully understood. In this cohort study, we examined the association between intelligence in early adulthood and later mortality from natural and unnatural causes taking birth weight, pa...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2013-202637
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Although pregnancy is a time when women have increased motivation to quit smoking, approximately half of female smokers persist in smoking throughout their pregnancies. Persistent pregnancy smokers are known to be more nicotine dependent and to have greater sociodemographic disadvantage. Less is known about ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2008.082594
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Adolescent drinking in Western countries has been associated with older age and high socioeconomic status, but the association with family structure was inconsistent. METHODS:In a 2012-2013 school-based survey in Hong Kong, 23,096 students (mean age 14.7 years, SD 1.8 years) completed an anonymous questionn...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2015-206418
更新日期:2016-04-01 00:00:00
abstract::The comparison of trends in ischaemic heart disease (IHD) mortality in different social classes is confounded by historical changes in diagnostic techniques and statistical classification, and possibly by different standards of diagnostic accuracy in the different social classes. The problems can be circumvented by ta...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.33.1.74
更新日期:1979-03-01 00:00:00
abstract:STUDY OBJECTIVE:It is increasingly recognised that different dimensions of social inequality may be linked to health by different pathways. Furthermore, factors operating at the individual level such as employment conditions may affect health in a different way from household level factors. The paper examines the assoc...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.57.1.56
更新日期:2003-01-01 00:00:00
abstract:STUDY OBJECTIVE:Understanding causes of variation in birth weight has been limited by lack of sufficient sets of data that include paternal birth weight. The objective was to estimate risks of low birth weight dependent on parental birth weights and to estimate father-mother-offspring correlations for birth weight to e...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.55.12.873
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:Although being employed during midlife is positively associated with cognitive function in later life, little is known with respect to cumulative trajectories or durations of time spent in different kinds of work. METHODS:We investigated the relationships between employment trajectory from ages 31 years to ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2018-211153
更新日期:2019-03-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the most appropriate surrogate indicator and its cut off point for identifying low birthweight babies in northern India. STUDY SETTING:A secondary level hospital at Ballabgarh. The patients were from nearby rural and urban areas and mostly belonged to lower and middle socioeconomic strata....
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.50.6.683
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:Cross-cohort comparison is an established method for improving causal inference. This study compared 2 cohorts, 1 from a high-income country and another from a middle-income country, to (1) establish whether birth exposures may play a causal role in the development of childhood attention problems; and (2) id...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2015-206222
更新日期:2016-07-01 00:00:00
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,多中心研究
doi:10.1136/jech-2015-206629
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Mental depression is an important health problem in many countries. It reduces productivity at work and is the fastest increasing reason for early retirement. METHODS:This study followed up a Finnish cohort of 1726 men from 1984 to 2000. Depression was assessed at baseline by HPL depression score. Pension r...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2003.010702
更新日期:2005-01-01 00:00:00
abstract:STUDY OBJECTIVE:The main cause of breast cancer remains unknown. Numerous causal factors or predisposing conditions have been proposed, but account for only a small percentage of the total disease. The current search for multiple causes is unavailing. This report explores whether any single aetiological agent may be re...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,评审
doi:10.1136/jech.54.11.851
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND:Reliable data on clinical biomarkers are necessary in order to assess the health risks of populations and especially in assessing long-term trends related to disease incidence. METHODS:Ten European laboratories participated in a two-phase quality control exercise of total cholesterol (TC) and high-density l...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2018-210763
更新日期:2018-07-01 00:00:00
abstract::Environmental pollutants and nutrients may be present in the same foodstuffs or dietary patterns; share internal mechanisms of transport, metabolism and cellular uptake; or target the same molecular signalling pathways and biological functions. Lipophilic pollutants and nutrients, like dioxins and polyunsaturated fatt...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2020-213789
更新日期:2021-02-01 00:00:00
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2009.090910
更新日期:2010-05-01 00:00:00
abstract::Much of the recent controversy surrounding the relation between fetal death and pregnancy order has centred around the appropriateness of different types of analyses. In the present paper the interpretation of various methods are discussed with reference to "real" and "hypothetical" data. The pattern of results obtain...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.38.1.29
更新日期:1984-03-01 00:00:00
abstract:BACKGROUND:Disparities in health among blacks and Hispanics compared to whites individuals exist for a number of health measures; however, the health profile of individuals who are both black and Hispanic is not well known. We sought to determine whether race and ethnicity have synchronous or independent effects on hea...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2009.103879
更新日期:2012-07-01 00:00:00
abstract::Prompted by my participation in the People's Climate March held in New York City on 21 September 2014, as part of the 'Harvard Divest' contingent, in this brief essay I reflect on the late 20th century development of--and debates over--the necessity of ecological thinking in epidemiology, and also the still limited en...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2014-205027
更新日期:2015-08-01 00:00:00
abstract::Eight hundred and ninety-nine men were studied, aged 16-65 inclusive, who underwent an elective inguinal herniorrhaphy during 1970 and 1971 in eight hospitals in Wessex, and under nine consultant surgeons. There was a significant variation in postoperative inpatient stay and total sickness absence between hospitals an...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.33.2.121
更新日期:1979-06-01 00:00:00
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更新日期:2018-09-01 00:00:00
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journal_title:Journal of epidemiology and community health
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更新日期:2016-04-01 00:00:00
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,随机对照试验
doi:10.1136/jech.2009.089185
更新日期:2010-03-01 00:00:00
abstract::The public health movement has been concerned with the relation between housing and health for well over a century. Nevertheless the Black Report still identified housing as one of the major causes of ill-health and suggested, on one indicator at least, that council housing is the least healthy form of tenure. An expl...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.39.1.15
更新日期:1985-03-01 00:00:00
abstract:OBJECTIVE:To describe the areas affected and the scale of an epidemic of thunderstorm associated asthma on the night of 24/25 June 1994 and to explore the spatial and temporal relationship between the thunderstorm and the associated epidemic. SETTING:The 29 offices of a deputising service for general practitioners' (G...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.51.3.233
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVES:Previous studies have implicated air pollution in increased mortality and morbidity, especially in the elderly population and children. More recently, associations with mortality in infants and with some reproductive outcomes have also been reported. The aim of this study is to explore the association betwee...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.58.1.11
更新日期:2004-01-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the short term relationship between air pollution and the daily number of emergency hospital admissions for respiratory disease. DESIGN:Data were analysed using autoregressive Poisson regression allowing for overdispersion and controlling for possible confounding factors such as seasonal and ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.50.suppl_1.s22
更新日期:1996-04-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the incidence of cancer among homeless men in Glasgow. DESIGN:Descriptive study of cancer incidence in a defined, though individually unidentifiable, population cohort. SETTING:Glasgow and the West of Scotland Region. PARTICIPANTS:Male residents of 10 hostels for the single homeless in G...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.51.6.668
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND:Whether or not, and how, health inequalities change throughout older age is currently under debate. The goal of this study was to assess the net impact of education, occupational class, income and wealth on frailty trajectories among older adults in Continental Europe. METHODS:We modelled frailty index traj...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2016-207712
更新日期:2017-01-01 00:00:00
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.44.4.293
更新日期:1990-12-01 00:00:00