Retrospective cohort study on women aged 70-74 attending breast cancer screening

Breast cancer screening is effective in reducing mortality from the disease. However, the sensitivity of mammography is not optimal, which limits the effectiveness of screening, particularly in younger women. In Italy, a one-year screening interval is recommended for all women aged 45-49, although it is likely that only women with dense breasts would benefit from such a short interval. For women aged 70-74, longer intervals may be more appropriate, in line with recent European recommendations. Italian regions are planning to expand the screening target population to include women aged 45-49 and 70-74. The MISS project aims to identify the optimal screening interval for breast cancer by conducting a trial that randomizes women aged 45 to: a) a 1-year interval, b) a 2-year interval, and c) a tailored interval based on breast density. Additionally, the project will include a large cohort study involving women aged 70-74, which will collect data from screening programs and cancer registries to compare the outcomes of women screened at the recommended intervals with those who experience delays.乳腺癌筛查可有效降低该疾病的死亡率。然而，乳腺钼靶摄影（mammography）的敏感性并非最优，这限制了筛查的应用效果，在年轻女性群体中尤为显著。在意大利，目前推荐对45至49岁的全体女性采用每年1次的筛查间隔，但仅有乳腺致密的女性或许能从如此短的间隔中获益。而对于70至74岁的女性，更长的筛查间隔则更为适宜，这与欧洲近期发布的筛查指南相符。当前意大利各地区正计划扩大乳腺癌筛查的目标人群，将45至49岁以及70至74岁的女性纳入筛查范围。 MISS项目旨在通过一项随机对照试验确定乳腺癌筛查的最优间隔：将45岁女性随机分为三组，a) 每年筛查1次组，b) 每两年筛查1次组，c) 基于乳腺密度制定的个性化筛查间隔组。此外，该项目还将开展一项针对70至74岁女性的大型队列研究，通过收集筛查项目与癌症登记处的相关数据，对比按推荐间隔接受筛查的女性与筛查延迟女性的临床结局。