Harvard Medical School, Boston, MA 02114, USA.
Curr Oncol. 2022 Aug 9;29(8):5644-5654. doi: 10.3390/curroncol29080445.
Quality medical practice is based on science and evidence. For over a half-century, the efficacy of breast cancer screening has been challenged, particularly for women aged 40-49. As each false claim has been raised, it has been addressed and refuted based on science and evidence. Nevertheless, misinformation continues to be promoted, resulting in confusion for women and their physicians. Early detection has been proven to save lives for women aged 40-74 in randomized controlled trials of mammography screening. Observational studies, failure analyses, and incidence of death studies have provided evidence that there is a major benefit when screening is introduced to the general population. In large part due to screening, there has been an over 40% decline in deaths from breast cancer since 1990. Nevertheless, misinformation about screening continues to be promoted, adding to the confusion. Despite claims to the contrary, a careful reading of the guidelines issued by major groups such as the U.S. Preventive Services Task Force and the American College of Physicians shows that they all agree that most lives are saved by screening starting at the age of 40. There is no scientific support for using the age of 50 as a threshold for screening. All women should be provided with the facts and not false information about breast cancer screening so that they can make "informed decisions" for themselves about whether to participate.
优质的医疗实践基于科学和证据。半个多世纪以来，乳腺癌筛查的效果一直受到质疑，尤其是对于 40-49 岁的女性。随着每一个虚假说法的提出，都基于科学和证据进行了探讨和反驳。然而，错误信息仍在不断传播，导致女性及其医生感到困惑。在对乳腺 X 线筛查进行的随机对照试验中，已经证明早期检测可以为 40-74 岁的女性挽救生命。观察性研究、失败分析和发病死亡研究提供了证据，表明在一般人群中进行筛查具有重大益处。在很大程度上由于筛查，自 1990 年以来，乳腺癌死亡人数下降了 40%以上。然而，有关筛查的错误信息仍在不断传播，这进一步加剧了混乱。尽管有人提出相反的说法，但仔细阅读美国预防服务工作组和美国医师学院等主要组织发布的指南可以发现，它们都同意大多数生命是通过从 40 岁开始的筛查挽救的。没有科学依据支持将 50 岁作为筛查的年龄阈值。应该向所有女性提供有关乳腺癌筛查的真实信息，而不是虚假信息，以便她们能够为自己是否参与做出“知情决策”。
