Department of Medicine, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Mason F Lord Building Center Tower, Room 711, Baltimore, MD 21224, USA.
Division of General Medicine and Clinical Epidemiology, Sheps Center for Health Services Research, University of North Carolina, 101 Parkview Crescent, Chapel Hill, NC 27516, USA.
Clin Geriatr Med. 2018 Feb;34(1):11-23. doi: 10.1016/j.cger.2017.09.002. Epub 2017 Oct 14.
The primary goal of cancer screening is early detection of cancer to reduce cancer-specific mortality and morbidity. The benefits of screening in older adults are uncertain due to paucity of evidence. Extrapolating data from younger populations, evidence suggests that the benefit occurs years later from the time of initial screening and therefore may not be applicable in those older adults with limited life expectancy. Contrast this with the harms of screening, which are more immediate and increase with age and comorbidities. An individualized approach to cancer screening takes these factors into consideration, allowing for thoughtful decision making for older adults.
癌症筛查的主要目标是早期发现癌症,以降低癌症特异性死亡率和发病率。由于证据不足,老年人进行筛查的益处尚不确定。从较年轻人群中推断的数据表明,益处是在初次筛查后多年才出现的,因此对于预期寿命有限的老年人可能并不适用。与之相比,筛查的危害更直接,且随着年龄和合并症的增加而增加。癌症筛查的个体化方法考虑了这些因素,为老年人进行深思熟虑的决策提供了依据。