Perleth M, Busse R, Gibis B, Brand A
Hannover Medical School.
Int J Technol Assess Health Care. 2001 Summer;17(3):329-37. doi: 10.1017/s0266462301106057.
In this article, three preventive strategies-mammography screening for breast cancer, PSA screening for prostate cancer, and routine ultrasound in normal pregnancy-are discussed in the context of German health care.
Epidemiologic data and German studies evaluating different aspects of these preventive measures were identified and analyzed.
Only a few studies could be identified that investigate these preventive measures. Despite sufficient evidence, in part derived from a German study, there is not yet a mammography screening program. In contrast, ultrasound in pregnancy is offered routinely, although there are controversies regarding the benefit of this practice. PSA screening is not offered as part of the screening program for prostate cancer. However, PSA tests as well as mammographies are done in large numbers in German ambulatory care-a practice that could be considered wild or opportunistic screening.
These case studies show that preventive programs and practices in Germany are not sufficiently based on sound evidence. The paucity of evaluation activities related to prevention in Germany is probably due to the low threshold to introduce new preventive programs into the German healthcare system in the past.
在本文中，将在德国医疗保健的背景下讨论三种预防策略——乳腺癌的乳房X线筛查、前列腺癌的前列腺特异性抗原（PSA）筛查以及正常孕期的常规超声检查。
识别并分析了评估这些预防措施不同方面的流行病学数据及德国研究。
仅能找到少数几项研究来调查这些预防措施。尽管部分证据源自一项德国研究且证据充分，但德国尚未开展乳房X线筛查项目。相比之下，孕期超声检查是常规提供的，尽管对于这种做法的益处存在争议。PSA筛查并未作为前列腺癌筛查项目的一部分提供。然而，在德国门诊医疗中，大量进行PSA检测和乳房X线检查——这种做法可被视为随意或机会性筛查。
这些案例研究表明，德国的预防项目和做法没有充分基于可靠证据。德国与预防相关的评估活动匮乏，可能是由于过去在德国医疗保健系统中引入新预防项目的门槛较低。
Zotero 插件