日本女性の乳癌死を減少させることは可能か（５）日本女性乳癌のリスク因子解析による検診推奨者について

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  • Identification of Women Targeted for a Breast Cancer Screening Program

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In order to reduce mortality due to breast cancer, we conducted a case-control study of breast cancer to evaluate potential risk factors, and eventually to identify women for whom breast cancer screening is highly recommended. The study included 2, 103 cases of primary breast cancer treated surgically at the Sapporo-Kotoni Breast Clinic and disease-free controls recruited from the same clinic. This allowed us to identify the following characteristics of women on whom breast cancer screening should be focused.<BR>(1) High-risk group less than 35 years old : i) Menarche at 11 years old or under; ii) History of benign breast disease; iii) History of cancer other than breast cancer. (2) Pre-menopausal group : i) Early menarche, especially at 11 years old or under; ii) Underweight (BMI<18. 5); iii) Married, but not parous; iv) Parous, but no history of breast-feeding; v) Unmarried; vi) Family history of breast cancer in a first-degree or second-degree relative. (3) Post-menopausal group : i) Underweight (BMI<18.5) or obese (BMI≥25.0); ii) Overweight (≥58.0kg); iii) Married, but not parous; iv) Parous, but no history of breast-feeding; v) Unmarried.<BR>The aim of breast cancer screening is not to decrease the incidence of breast cancer but to reduce mortality due to the cancer. The Japanese Ministry of Welfare and Labor has advocated an increase in the rate of breast cancer screening to about 39% in 2010 (50% increase from 1997). However, even after complete adoption of this plan, more than half of women would still not undergo breast cancer screening. Accordingly, in order to achieve an effective screening program, women that are most likely to benefit from breast cancer screening need to be identified and targeted.

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