Chief Cancer Control Officer, American Cancer Society, Atlanta, GA.
Chief Medical Officer, American Cancer Society, Atlanta, GA.
CA Cancer J Clin. 2019 Jan;69(1):50-79. doi: 10.3322/caac.21550. Epub 2018 Nov 19.
From the mid-20th century, accumulating evidence has supported the introduction of screening for cancers of the cervix, breast, colon and rectum, prostate (via shared decisions), and lung. The opportunity to detect and treat precursor lesions and invasive disease at a more favorable stage has contributed substantially to reduced incidence, morbidity, and mortality. However, as new discoveries portend advancements in technology and risk-based screening, we fail to fulfill the greatest potential of the existing technology, in terms of both full access among the target population and the delivery of state-of-the art care at each crucial step in the cascade of events that characterize successful cancer screening. There also is insufficient commitment to invest in the development of new technologies, incentivize the development of new ideas, and rapidly evaluate promising new technology. In this report, the authors summarize the status of cancer screening and propose a blueprint for the nation to further advance the contribution of screening to cancer control.
从 20 世纪中期开始，越来越多的证据支持开展宫颈癌、乳腺癌、结肠癌和直肠癌、前列腺癌（通过共同决策）以及肺癌的筛查。通过这种方式在更有利的阶段发现和治疗癌前病变和侵袭性疾病，显著降低了发病率、患病率和死亡率。然而，随着新发现预示着技术和基于风险的筛查的进步，我们未能充分发挥现有技术的最大潜力，无论是在目标人群中的全面普及，还是在成功癌症筛查事件级联的每个关键步骤中提供最先进的护理。此外，也没有足够的决心投资于新技术的开发，激励新想法的产生，以及快速评估有前途的新技术。在本报告中，作者总结了癌症筛查的现状，并为国家进一步推动筛查对癌症控制的贡献提出了蓝图。
