Kopans Daniel B, Webb Matthew L, Cady Blake
Harvard Medical School, Boston, Massachusetts; Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Cancer. 2014 Sep 15;120(18):2792-9. doi: 10.1002/cncr.28791. Epub 2014 Jun 12.
Mammography screening fulfills all requirements for an effective screening test. It detects many cancers earlier when they are at a smaller size and earlier stage, and it has been demonstrated that this reduces breast cancer deaths in randomized controlled trials. When screening is introduced into the population, the death rate from breast cancer declines. Nevertheless, scientifically unsupported arguments that appear in the medical literature are passed on to the public and continue to confuse women and physicians regarding the value of screening. Methodologically flawed challenges to mammography have been almost continuous since the 1990s. And, as each challenge has been invalidated, a new, specious challenge has been raised. The authors of this report address the long history of misinformation that has developed in the effort to reduce access to screening, and they address the issues raised by commentators concerning their recent publication in this journal.
乳腺钼靶筛查满足有效筛查测试的所有要求。它能在许多癌症处于较小尺寸和早期阶段时更早地检测到,并且在随机对照试验中已证明这能降低乳腺癌死亡率。当在人群中引入筛查时,乳腺癌死亡率会下降。然而,医学文献中出现的未经科学证实的观点被传递给公众,并且在筛查的价值方面继续使女性和医生感到困惑。自20世纪90年代以来,对乳腺钼靶的方法学上有缺陷的质疑几乎从未间断。而且,每当一项质疑被证明无效时,就会出现一个新的似是而非的质疑。本报告的作者探讨了在减少筛查可及性的努力中形成的长期错误信息历史,并回应了评论者就他们近期在本期刊上发表的文章所提出的问题。