Kramer B S, Gohagan J, Prorok P C
Division of Cancer Prevention and Control, National Cancer Institute, Bethesda, Maryland 20892.
Gynecol Oncol. 1994 Dec;55(3 Pt 2):S20-1. doi: 10.1006/gyno.1994.1335.
Frequently, the medical and lay community has assumed that earlier diagnosis of cancer of any type automatically confers benefit and that any diagnostic test that can identify early stages of disease must therefore be useful for screening. However, there is an emerging science of screening which affords a more rigorous approach to public health recommendations in the application of new technologies to screening and early detection. A number of public health groups and agencies are using an evidence-based approach in making recommendations. Using this approach, early detection methods for ovarian cancer would meet only the weakest level of evidence to support their routine application in asymptomatic women. For this reason, the National Cancer Institute has recently launched a large randomized clinical trial to test the effectiveness of screening for ovarian cancer.
医学和普通大众常常认为,任何类型癌症的早期诊断必然会带来益处,因此,任何能够识别疾病早期阶段的诊断测试都必定对筛查有用。然而,一门新兴的筛查科学正在兴起,它为在新技术应用于筛查和早期检测时提出公共卫生建议提供了更为严谨的方法。一些公共卫生组织和机构正在采用基于证据的方法来提出建议。采用这种方法,卵巢癌的早期检测方法仅能满足支持其在无症状女性中常规应用的最弱证据水平。出于这个原因,美国国立癌症研究所最近开展了一项大型随机临床试验,以测试卵巢癌筛查的有效性。