Zoorob R, Anderson R, Cefalu C, Sidani M
Louisiana State University of Medicine, Department of Family Medicine, New Orleans, USA.
Am Fam Physician. 2001 Mar 15;63(6):1101-12.
Numerous medical organizations have developed cancer screening guidelines. Faced with the broad, and sometimes conflicting, range of recommendations for cancer screening, family physicians must determine the most reasonable and up-to-date method of screening. Major medical organizations have generally achieved consensus on screening guidelines for breast, cervical and colorectal cancer. For breast cancer screening in women ages 50 to 70, clinical breast examination and mammography are generally recommended every one or two years, depending on the medical organization. For cervical cancer screening, most organizations recommend a Papanicolaou test and pelvic examination at least every three years in patients between 20 and 65 years of age. Annual fecal occult blood testing along with flexible sigmoidoscopy at five-year to 10-year intervals is the standard recommendation for colorectal cancer screening in patients older than 50 years. Screening for prostate cancer remains a matter of debate. Some organizations recommend digital rectal examination and a serum prostate-specific antigen test for men older than 50 years, while others do not. In the absence of compelling evidence to indicate a high risk of endometrial cancer, lung cancer, oral cancer and ovarian cancer, almost no medical organizations have developed cancer screening guidelines for these types of cancer.
众多医学组织已制定了癌症筛查指南。面对癌症筛查广泛且有时相互冲突的一系列建议,家庭医生必须确定最合理且最新的筛查方法。主要医学组织在乳腺癌、宫颈癌和结直肠癌的筛查指南方面总体上已达成共识。对于50至70岁女性的乳腺癌筛查,根据医学组织的不同,一般建议每1至2年进行一次临床乳腺检查和乳房X线摄影。对于宫颈癌筛查,大多数组织建议20至65岁的患者至少每3年进行一次巴氏试验和盆腔检查。对于50岁以上患者的结直肠癌筛查,标准建议是每年进行粪便潜血检测,并每5至10年进行一次乙状结肠镜检查。前列腺癌筛查仍然存在争议。一些组织建议对50岁以上男性进行直肠指检和血清前列腺特异性抗原检测,而其他组织则不建议。在缺乏表明子宫内膜癌、肺癌、口腔癌和卵巢癌高风险的有力证据的情况下,几乎没有医学组织为这些类型的癌症制定癌症筛查指南。