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癌症发病率与死亡率:筛查频率及人群覆盖范围的优先事项

Cancer incidence and mortality: the priority of screening frequency and population coverage.

作者信息

Colditz G A, Hoaglin D C, Berkey C S

机构信息

Harvard University, Abt Associates Inc., Cambridge, Massachusetts, USA.

出版信息

Milbank Q. 1997;75(2):147-73. doi: 10.1111/1468-0009.00050.

Abstract

In addition to the usual measures of screening-test performance, it is important to consider testing frequency when evaluating a screening program. Data on which to base recommendations for the timing of screening tests are urgently needed. For example, in the cases of cervical and colon cancer, when the target is a precursor lesion, research indicates that less frequent screening may be appropriate. This finding may not apply, however, to screening for breast cancer by mammography, which requires currently recommended intervals for the early detection of malignancies. Resources now allocated to breast cancer might more effectively be applied to the construction of tests that would permit longer intervals between screenings. To achieve the National Cancer Institute's goal of reducing cancer mortality in the United States by the year 2000, it will be important to review the balance between population coverage and individual screening for each cancer and to emphasize prevention strategies that maximize population coverage while minimizing expenditures.

摘要

除了筛查测试性能的常规指标外,在评估筛查项目时考虑检测频率很重要。迫切需要有关确定筛查测试时间的建议依据的数据。例如,对于宫颈癌和结肠癌,当目标是癌前病变时,研究表明较低频率的筛查可能是合适的。然而,这一发现可能不适用于通过乳房X线摄影筛查乳腺癌,目前乳腺癌筛查需要按照推荐的间隔时间来进行以早期发现恶性肿瘤。现在分配给乳腺癌筛查的资源可能更有效地用于开发能够允许更长筛查间隔的检测方法。为实现美国国立癌症研究所到2000年降低癌症死亡率的目标,重要的是要审视每种癌症在人群覆盖和个体筛查之间的平衡,并强调预防策略,即在尽量减少支出的同时最大限度地扩大人群覆盖范围。

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