乳がんと前立腺がんのスクリーニングの再考
Laura Esserman1, Yiwey Shieh, Ian Thompson
1Department of Surgery and Radiology, University of California, San Francisco, San Francisco, CA 94115, USA. laura.esserman@ucsfmedctr.org
JAMA
|October 22, 2009
まとめ
20年以上にわたる乳がんと前立腺がんのスクリーニングは,発生率と早期診断の増加を示し,低リスク症例の過剰診断の可能性が高い. 癌による死亡率を減らすために,新しいスクリーニングと早期発見戦略が必要である.
科学分野:
- 腫瘍学 腫瘍学
- 公衆衛生は公衆衛生である.
- 癌のスクリーニング
背景:
- 20年間の乳がんと前立腺がんのスクリーニングデータを分析した.
- 癌の発生率と診断時のステージにおける観察された傾向.
研究 の 目的:
- 癌検診プログラムの長期的な影響を評価する.
- 癌による死亡率を下げるための現在のスクリーニングの有効性を評価する.
- 癌のスクリーニングと早期発見のための新しいアプローチを提案します.
主な方法:
- 癌発生率のデータの縦断分析.
- スクリーニング実施前と後の癌のステージ分布の比較.
- スクリーニングプログラムに関連した死亡率の傾向の評価.
主要な成果:
- 癌の発生率はスクリーニング導入後増加し,ベースラインに戻っていません.
- 早期がん診断の割合が著しく増加した.
- 地域性がんの発生率は比例して減少しなかったため,攻撃性疾患への影響は限られたことを示唆している.
結論:
- 現在のスクリーニングは,低リスクがんの過剰診断につながる可能性があります.
- スクリーニングは,攻撃的ながんによる死亡率を効果的に削減していない可能性があります.
- 検診,早期発見,予防のための新しい戦略は,乳がんや前立腺がんにとって極めて重要です.
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