{"id":25334,"date":"2024-02-18T04:20:00","date_gmt":"2024-02-17T20:20:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=25334"},"modified":"2024-02-18T06:01:40","modified_gmt":"2024-02-17T22:01:40","slug":"jama%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e7%be%8e%e5%9b%bd1975-2019%e5%b9%b4%e9%97%b4%e4%b9%b3%e8%85%ba%e7%99%8c%e6%ad%bb%e4%ba%a1%e7%8e%87%e7%9a%84%e5%88%86%e6%9e%90","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=25334","title":{"rendered":"[JAMA\u53d1\u8868\u8bba\u6587]\uff1a\u7f8e\u56fd1975-2019\u5e74\u95f4\u4e73\u817a\u764c\u6b7b\u4ea1\u7387\u7684\u5206\u6790"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

January 16, 2024<\/p>\n\n\n\n

Analysis of Breast Cancer Mortality in the US\u20141975 to 2019<\/h1>\n\n\n\n

Jennifer L.\u00a0Caswell-Jin,\u00a0Liyang P.\u00a0Sun,\u00a0Diego\u00a0Munoz,\u00a0et al<\/h3>\n\n\n\n

JAMA.\u00a0<\/em>2024;331(3):233-241. doi:10.1001\/jama.2023.25881<\/h3>\n\n\n\n

<\/a>Key Points<\/p>\n\n\n\n

Question<\/strong>  What are the relative associations of breast cancer screening, treatment of stage I to III breast cancer, and treatment of metastatic breast cancer with improved breast cancer mortality in the US between 1975 and 2019?<\/p>\n\n\n\n

Findings<\/strong>  Improvements in treatment and screening after 1975 were associated with a 58% reduction in breast cancer mortality in 2019, from an estimated 64 deaths without intervention to 27 per 100\u202f000 women (age adjusted). Approximately 29% of this reduction was associated with treating metastatic breast cancer, 25% with screening, and 47% with treating stage I to III breast cancer.<\/p>\n\n\n\n

Meaning<\/strong>  Based on 4 simulation models, breast cancer screening, treatment of stage I to III breast cancer, and treatment of metastatic breast cancer were each associated with reduced breast cancer mortality between 1975 and 2019 in the US.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Breast cancer mortality in the US declined between 1975 and 2019. The association of changes in metastatic breast cancer treatment with improved breast cancer mortality is unclear.<\/p>\n\n\n\n

Objective<\/strong>  To simulate the relative associations of breast cancer screening, treatment of stage I to III breast cancer, and treatment of metastatic breast cancer with improved breast cancer mortality.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  Using aggregated observational and clinical trial data on the dissemination and effects of screening and treatment, 4 Cancer Intervention and Surveillance Modeling Network (CISNET) models simulated US breast cancer mortality rates. Death due to breast cancer, overall and by estrogen receptor and ERBB2<\/em> (formerly HER2<\/em>) status, among women aged 30 to 79 years in the US from 1975 to 2019 was simulated.<\/p>\n\n\n\n

Exposures<\/strong>  Screening mammography, treatment of stage I to III breast cancer, and treatment of metastatic breast cancer.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  Model-estimated age-adjusted breast cancer mortality rate associated with screening, stage I to III treatment, and metastatic treatment relative to the absence of these exposures was assessed, as was model-estimated median survival after breast cancer metastatic recurrence.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0The breast cancer mortality rate in the US (age adjusted) was 48\/100\u202f000 women in 1975 and 27\/100\u202f000 women in 2019. In 2019, the combination of screening, stage I to III treatment, and metastatic treatment was associated with a 58% reduction (model range, 55%-61%) in breast cancer mortality. Of this reduction, 29% (model range, 19%-33%) was associated with treatment of metastatic breast cancer, 47% (model range, 35%-60%) with treatment of stage I to III breast cancer, and 25% (model range, 21%-33%) with mammography screening. Based on simulations, the greatest change in survival after metastatic recurrence occurred between 2000 and 2019, from 1.9 years (model range, 1.0-2.7 years) to 3.2 years (model range, 2.0-4.9 years). Median survival for estrogen receptor (ER)\u2013positive\/ERBB2<\/em>-positive breast cancer improved by 2.5 years (model range, 2.0-3.4 years), whereas median survival for ER\u2212<\/em>\/ERBB2\u2212<\/em>\u00a0breast cancer improved by 0.5 years (model range, 0.3-0.8 years).<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  According to 4 simulation models, breast cancer screening and treatment in 2019 were associated with a 58% reduction in US breast cancer mortality compared with interventions in 1975. Simulations suggested that treatment for stage I to III breast cancer was associated with approximately 47% of the mortality reduction, whereas treatment for metastatic breast cancer was associated with 29% of the reduction and screening with 25% of the reduction.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  January 16, 2024 […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25334"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=25334"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25334\/revisions"}],"predecessor-version":[{"id":25335,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25334\/revisions\/25335"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=25334"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=25334"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=25334"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}