Wolf A M, Becker D M
Department of Medicine, University of Virginia Health Sciences Center, Charlottesville, USA.
Arch Intern Med. 1996 May 27;156(10):1069-72.
While screening for asymptomatic cancer has become one of the principal clinical activities of primary care physicians, patients are generally not involved directly in screening decisions. To help physicians better communicate the potential benefits and burdens of cancer screening, this article concisely presents information necessary for patients to make a reasoned decision as to whether to proceed with screening: the probability of developing cancer, the operating characteristics of available screening tests, the likelihood that screening will result in an improved outcome for the individual patient, and the potential burdens associated with screening. Screening tests for breast, colorectal, cervical, and prostate cancers are reviewed, including mammography, clinical breast examination, fecal occult blood testing, Papanicolaou smear, digital rectal examination, and prostate-specific antigen. Better communication about cancer screening will promote shared decision making--a central tenet of the physician-patient relationship.
虽然筛查无症状癌症已成为初级保健医生的主要临床活动之一，但患者通常并不直接参与筛查决策。为帮助医生更好地传达癌症筛查的潜在益处和负担，本文简要介绍了患者就是否进行筛查做出合理决策所需的信息：患癌概率、现有筛查测试的操作特征、筛查对个体患者改善预后的可能性以及与筛查相关的潜在负担。本文对乳腺癌、结直肠癌、宫颈癌和前列腺癌的筛查测试进行了综述，包括乳房X光检查、临床乳房检查、粪便潜血检测、巴氏涂片检查、直肠指检和前列腺特异性抗原检测。关于癌症筛查的更好沟通将促进共同决策，这是医患关系的核心原则。
