https://scholars.lib.ntu.edu.tw/handle/123456789/112407| Title: | 癌症篩檢效益評估---芬蘭-瑞典-台灣三國合作計畫 | Authors: | 陳秀熙 陳秀熙 |
Keywords: | 子宮頸癌篩檢;乳癌篩檢;攝護腺;癌篩檢;前導期校正;Screening has been regarded as the most important prevention method for cervical cancer, breast cancer, colorectal cancer, and perhaps prostate cancer, and the disease natural history plays an important role in the effectiveness of screening. The long disease natural history not only enables one to detect cancers at early stage but also produces good program sensitivity and specificity if the inter-screening interval is adequate. This project is a part of Finnish-Swedish- Taiwanese Cooperation Project which is based on the collaboration between Academy of Finland, Sweden and the National Science Council in Taiwan to find out common areas of interest and to develop plans for collaborative research in epidemiology. This present project which belongs to the first topic, cancer screening, was proposed to facilitate Finnish-Swedish-Taiwanese cooperative research on the formulation of evidence-based method for evaluation of cancer screening. The specific aims of the present study are to: 1. to evaluate the effectiveness of population2 based prostatic cancer screening trial with PSA measurement in Finland. 2. evaluate breast cancer screening using data from Finland 3. continue evaluation cervical cancer screening using data from Finland. Materials and Methods: We first develop the disease natural history from normal via preclinical state, clinical state, to cancer death, and estimate each transition parameters of the model. Based on these empirical estimates, A hypothetical cohort of 100,000 subjects with identical make-up of demographic characteristics is simulated. Results: 1. Prostate cancer screening: The hazard ratio comparing screen-detected cancers with clinically-detected cancers inflates from 0.13 to 0.73 after lead-time adjustment. The results show that lead-time bias plays an important role on prostate cancer survival when comparing screen-detected cases with clinically- detected cases. More detailed data on screening for both breast cancer and cervical cancer are needed to build up a comprehensive natural history model. Conclusions In conclusion, bilateral cooperation projects has been feasibly demonstrated by exchanging PhD student who has actively participated in cancer screening project in Finland. The comparison of cumulative survival between screen-detected cases and clinically-detected cases for prostate cancer screening project has been made. Preparation of data on breast cancer screening and cervical cancer screening has been implemented. Future analysis on two screening regimes should be done.;Cervical Cancer Screening;Breast Cancer screening;Prostate Cancer Screening;Lead-time Adjustment | Issue Date: | 31-Jul-2004 | Publisher: | 臺北市：國立臺灣大學公共衛生學院預防醫學研究所 | Abstract: | 篩檢被視為防治子宮頸癌、乳癌、大腸 直腸癌、及(或許)攝護腺癌最重要的防治方 式，且其自然病史在篩檢活動的成效扮演了 相當重要的角色。疾病的自然病史不只有助 於我們在癌症的早期將其發現，也產出好的 感度度與特異度。 本計畫隸屬於中芬瑞國際合作計畫中， 而中芬瑞國際合作計畫目的在於找出三國共 同有興趣的研究主題並發展與流行病學相關 的共同合作研究計畫。本計畫即屬於該國際 合作計畫下的其中一個主題—癌症篩檢，希 望透過本計畫的執行，以實證醫學為基礎的 癌症篩檢評量來促進中芬瑞三國之間在研究 上的合作關係。本計畫的主要目的為： 1. 評估以族群為基礎攝護腺癌篩檢隨機試 驗。 2. 評估芬蘭乳癌篩檢資料 3. 評估芬蘭子宮頸癌篩檢資料 材料與方法：我們首先發展疾病自然病史模 式，從正常到臨床症前期、臨床期再到死亡， 並用芬蘭的實證資料來對每個階段進行估 計，再根據這些估計值來進行100,000 位虛 擬族群的電腦模擬，以比較在不同的篩檢策 略下的篩檢效益。 結果： 1. 攝護腺癌：在調整前導期偏差後，篩檢偵 測個案相對於臨床偵測個案之死亡相對 危險性為0.13 至0.73 之間。結果顯示前 導期偏差的調整對於篩檢偵測個案及臨 床偵測個案在存活率的比較上影響頗大。 2. 乳癌及子宮頸癌篩檢評估部份已完成資 料處理及準備等部份，我們發現完整的自 然病史探討尚需要更為詳細的資料(如不 同轉移模式的資料、腫瘤特徵及篩檢間隔 個案等)來建構。 結論 總結來說，我們透過此中芬瑞國際合作計劃 將臺灣博士班交換學生送往芬蘭，並且參與 該國癌症篩檢研究計畫，並已完成該國攝護 腺癌篩檢計畫下篩檢偵測個案及臨床偵測個 案其存活率之比較。此外，該生亦活躍於該 國乳癌及子宮頸癌篩檢評估計畫當中的資料 處理及準備等部份，並且預備在不久的將來 針對這兩種癌症進行更進一步的分析。 |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/4714 | Other Identifiers: | 912320B002215 | Rights: | 國立臺灣大學公共衛生學院預防醫學研究所 |
| Appears in Collections: | 流行病學與預防醫學研究所 |
| File | Description | Size | Format | |
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| 912320B002215.pdf | 120.11 kB | Adobe PDF | View/Open |
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