Hulka B S
J Occup Med. 1986 Aug;28(8):687-91. doi: 10.1097/00043764-198608000-00030.
The purpose of this paper is to clarify the objectives of screening programs, particularly for cancer, characteristics of diseases suitable for screening, features of suitable screening tests, levels of program evaluation, and evidence on the advantages and disadvantages of screening. Diseases suitable for screening are those leading to serious morbidity and high mortality, those with a prolonged preclinical phase in their natural course, and those for which effective therapy is available following early diagnosis. Useful screening procedures have documented validity, acceptability, and safety and are performed with relative ease and modest cost. These generic issues in cancer screening are examined in the context of screening for cervical, breast, and lung cancer. Each of these cancers illustrates how to weigh different kinds of evidence when advocating or rejecting screening.
本文的目的是阐明筛查项目的目标，尤其是癌症筛查项目的目标、适合筛查的疾病特征、合适筛查检测的特点、项目评估水平以及筛查利弊的证据。适合筛查的疾病是那些会导致严重发病和高死亡率的疾病、自然病程中有较长临床前期的疾病，以及早期诊断后有有效治疗方法的疾病。有用的筛查程序已证明具有有效性、可接受性和安全性，并且操作相对简便、成本适中。这些癌症筛查中的一般性问题将在宫颈癌、乳腺癌和肺癌筛查的背景下进行探讨。每种癌症都说明了在提倡或拒绝筛查时如何权衡不同类型的证据。
