German Childhood Cancer Registry, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Germany.
Dtsch Arztebl Int. 2012 May;109(21):385-90. doi: 10.3238/arztebl.2012.0385. Epub 2012 May 25.
The early detection of cancer and other diseases is generally considered beneficial, yet there is evidence that in some diseases screening may be of limited benefit. To clarify this issue, we present the statistical principles that underlie screening. Methods We define screening and discuss the conditions for its successful use. We give illustrative examples from among the currently recommended types of screening in Germany and from the recent medical literature, particularly with regard to mammography.
Certain specific conditions must be fulfilled for screening to be beneficial (usually measured by reduced mortality): The screening procedure must be of high quality, and the screening intervals must be well adapted to the distribution of the sojourn time. Alongside its benefits, screening can also cause harm, particularly to the many patients who are given a false positive test result. According to German law, potential participants are entitled to being given all information necessary to make an informed decision about screening.
Just like clinical interventions, screening programs should be evaluated before they are introduced or, at the latest, at the time of their introduction.
癌症和其他疾病的早期检测通常被认为是有益的，但有证据表明，在某些疾病中，筛查的益处可能有限。为了澄清这个问题，我们介绍了筛查所依据的统计原理。
我们定义了筛查，并讨论了其成功应用的条件。我们给出了来自德国目前推荐的筛查类型和最近医学文献中的说明性示例，特别是乳腺 X 线摄影术。
筛查要有益处（通常通过降低死亡率来衡量），必须满足某些特定条件：筛查程序必须具有高质量，并且筛查间隔必须与逗留时间的分布很好地适应。除了益处之外，筛查还可能带来危害，特别是对许多被给予假阳性检测结果的患者。根据德国法律，潜在参与者有权获得有关筛查做出知情决策所需的所有必要信息。
就像临床干预一样，在引入筛查计划之前或在引入时就应该对其进行评估。
