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[妇科肿瘤学中的筛查]

[Screening in gynecologic oncology].

作者信息

Ebeling K

出版信息

Zentralbl Gynakol. 1983;105(19):1225-38.

PMID:6316692
Abstract

Practical value of screening depends on various characteristics of cancers themselves, suitable tests and programs being able to cover a sufficient part of the population. Cancers favourable for screening are those with a high prevalence in the population screened, a detectable preclinical stage and better treatment results if detected by screening than detected by symptoms. Suitable screening tests have to be highly sensitive and specific, simple, cheap and without any risk. Before the widespread application of a screening program as a public health measure scientific basis and rational organization should be well known and the benefit has to be evident. Cytological screening is the most effective measure in cervical cancer control. Screening also promises a reduction in mortality from breast cancer, but further evaluation is necessary before decisions can be made about the application as a public health measure. Selective screening is probably connected with an improved health care for high risk persons of endometrial cancer. Follow up with HCG-RIA after hydatidiform mole improves early detection and prognosis of trophoblastic neoplasias significantly.

摘要

筛查的实用价值取决于癌症本身的各种特征、合适的检测方法以及能够覆盖足够比例人群的项目。适合筛查的癌症是那些在被筛查人群中患病率高、有可检测的临床前期阶段且通过筛查发现比通过症状发现治疗效果更好的癌症。合适的筛查检测必须具有高敏感性和特异性、简单、廉价且无任何风险。在将筛查项目作为一项公共卫生措施广泛应用之前,其科学依据和合理组织应广为人知,且益处必须明显。细胞学筛查是控制宫颈癌最有效的措施。筛查也有望降低乳腺癌死亡率,但在决定将其作为一项公共卫生措施应用之前,还需要进一步评估。选择性筛查可能与改善子宫内膜癌高危人群的医疗保健有关。葡萄胎后采用人绒毛膜促性腺激素放射免疫测定法进行随访可显著提高滋养细胞肿瘤的早期发现率和预后。

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