Lynge Elsebeth
Institut for Folkesundhedsvidenskab, Københavns Universitet, DK-2200 København N.
Ugeskr Laeger. 2002 May 27;164(22):2892-7.
Screening makes it possible to detect cancer before the disease gives rise to symptoms. A more effective treatment could thus be offered, and patients would then have a better prognosis. If screening works, mortality from a given cancer disease should decline in the screened population. At present three screening tests meet this requirement: 1) Pap smears for cervical dysplasia, with screening started at the latest at the age of 30 and not before the age of 20; 2) Mammography screening for breast cancer in women aged 50-69; and 3) faecal occult blood testing for colorectal cancer in men and women aged 50-74. But screening means the testing of healthy persons for cancer, and it therefore has a number of negative side effects, such as false positive and false negative tests. Whether or not screening is preferable in a given situation therefore depends on how the advantages are weighted against the disadvantages.
筛查能够在癌症出现症状之前检测出癌症。这样就能提供更有效的治疗方法,患者的预后也会更好。如果筛查有效,特定癌症疾病的死亡率在接受筛查的人群中应该会下降。目前有三项筛查测试符合这一要求:1)针对宫颈发育异常的巴氏涂片检查,筛查最晚从30岁开始,20岁之前不进行;2)对50至69岁女性进行乳腺癌的乳房X光筛查;3)对50至74岁的男性和女性进行结直肠癌的粪便潜血检测。但筛查意味着对健康人进行癌症检测,因此会有一些负面副作用,比如假阳性和假阴性检测结果。所以在特定情况下筛查是否可取取决于如何权衡利弊。