[乳腺癌钼靶筛查中的过度诊断]
[Overdiagnosis in mammography screening for breast cancer].
作者信息
Huang Y B, Yang L, Song F J, Chen K X
机构信息
Department of Epidemiology and Biostatistics, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy of Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China.
Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital and Institute, Beijing 100142, China.
出版信息
Zhonghua Liu Xing Bing Xue Za Zhi. 2017 Nov 10;38(11):1574-1578. doi: 10.3760/cma.j.issn.0254-6450.2017.11.027.
Screening has been always considered as a double-edged sword. Cancer screening could save lives in some cases, however, in other cases, it might also turn people into overdiagnosis. Overdiagnosis is the diagnosis of cancer that will never cause symptoms or death during a patient's lifetime. Therefore, overdiagnosis might lead to unnecessary treatments and lifetime surveillance, and then increase economic burden and psychological burden. In this review, we focus on how to correctly evaluate the overdiagnosis rate, and how to avoid or reduce the harms caused by overdiagnosis in the future according to the reasons associated with overdiagnosis. After systematically reviewing the previous studies, we will try to identify the potential reasons associated with overdiagnosis in breast cancer screening with mammography, address how to correctly evaluate the overdiagnosis rate, and finally provide some suggestions to reduce the overdiagnosis.
筛查一直被视为一把双刃剑。癌症筛查在某些情况下可以挽救生命,然而,在其他情况下,它也可能导致过度诊断。过度诊断是指诊断出的癌症在患者一生中永远不会引起症状或导致死亡。因此,过度诊断可能会导致不必要的治疗和终身监测,进而增加经济负担和心理负担。在本综述中,我们关注如何正确评估过度诊断率,以及如何根据与过度诊断相关的原因在未来避免或减少过度诊断造成的危害。在系统回顾先前的研究后,我们将试图确定乳腺钼靶筛查乳腺癌中与过度诊断相关的潜在原因,探讨如何正确评估过度诊断率,最后提供一些减少过度诊断的建议。