PO.PR01.02 · 预防研究
全球乳腺癌筛查指标差异分析：一项系统分析
Analysis of variation in global breast cancer screening indicators: A systematic analysis
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摘要 Abstract
中文摘要
背景：乳腺癌筛查的覆盖率是衡量筛查有效性的关键指标。目前关于全球乳腺癌筛查覆盖率的综合性研究仍然不足，现有证据表明许多地区的筛查率仍不理想。因此，本研究旨在系统评估全球乳腺癌筛查项目的现状，并重点分析其覆盖情况。基于现有数据，我们系统梳理并呈现了全球、区域和国家层面乳腺癌筛查的实施情况。
方法：我们系统检索了PubMed、Web of Science和Embase数据库（自建库至2025年8月12日），并补充检索了相关官方网站和世界卫生组织数据库。共纳入了75个国家和地区的乳腺癌筛查政策及覆盖率数据。纳入的关键信息包括：筛查方法、筛查间隔以及提供免费服务的具体情况等。在此基础上，我们进一步分析了各国乳腺癌筛查指南的具体内容，并系统评估了全球筛查覆盖率的差异。为深入探究差异背后的影响因素，我们根据人类发展指数（HDI）水平、大洲分布、世界卫生组织（WHO）区域以及不同年龄组进行了详细的亚组分析。该系统综述已在PROSPERO进行前瞻性注册（注册号：CRD420251233260）。
结果：在纳入的75个国家和地区中，35个（46.7%）国家已建立官方乳腺癌筛查指南。就筛查方法而言，乳腺X线摄影/数字乳腺断层合成（DBT）是最常采用的方法，在49个（65.3%）国家使用。在资源有限的国家和地区，临床乳腺检查（CBE）是最常推荐的筛查方法。乳腺癌筛查的平均覆盖率为50.2%（95% CI：36.6%-58.8%）。按年龄分层分析显示，50-69岁年龄组的筛查覆盖率显著高于40-49岁和70-79岁年龄组。
结论：目前，全球大多数国家的乳腺癌筛查覆盖率仍处于相对较低的水平。为弥合这一差距，有必要系统识别影响因素、制定有针对性的策略并积极推动其实施，以有效提升乳腺癌筛查的覆盖水平。
关键词：乳腺癌；乳腺癌筛查；覆盖率；系统综述
查看英文原文 English abstract
Background : The coverage rate of breast cancer screening is a key indicator for measuring the effectiveness of screening. Comprehensive studies on the global coverage rate of breast cancer screening are still insufficient at present, and existing evidence suggests that screening rates remain suboptimal in many regions. Therefore, this study aims to systematically assess the current status of global breast cancer screening programs and focus on analyzing their coverage. Based on existing data, we have systematically sorted out and presented the implementation of breast cancer screening at the global, regional and national levels.
Methods: We systematically searched the PubMed, Web of Science, and Embase databases (from their inception to August 12, 2025), and supplemented the search with relevant official websites and the World Health Organization database. A total of 75 countries and regions' breast cancer screening policies and coverage data were included. The following key information was incorporated: screening methods, screening intervals, and specific circumstances of providing free services, etc. On this basis, we further analyzed the specific contents of breast cancer screening guidelines in various countries and systematically evaluated the global differences in screening coverage. To deeply explore the influencing factors behind the differences, detailed subgroup analyses were conducted based on the Human Development Index (HDI) level, continent distribution, World Health Organization (WHO) regions, and different age groups. The systematic review was prospectively registered in PROSPERO (registration number: CRD420251233260).
Results: Among the 75 countries and regions included, 35 (46.7%) countries have established official breast cancer screening guidelines. Regarding screening methods, mammography/digital breast tomosynthesis (DBT) is the most commonly adopted approach, used in 49 (65.3%) countries. In resource-limited countries and regions, clinical breast examination (CBE) is the most frequently recommended screening method. The average coverage rate of breast cancer screening is 50.2% (95% CI: 36.6%-58.8%). Stratified analysis by age shows that the screening coverage rate in the 50-69 age group is significantly higher than that in the 40-49 and 70-79 age groups.
Conclusions: At present, the coverage rate of breast cancer screening in most countries around the world remains at a relatively low level. To bridge this gap, it is necessary to systematically identify influencing factors, formulate targeted strategies, and actively promote their implementation to effectively enhance the coverage level of breast cancer screening.
Key words: Breast cancer; Breast cancer screening; Coverage rate; Systematic review
利益披露 Disclosure
J. Guo, None..
R. Xin, None..
X. Wu, None..
B. Zhu, None.