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進行がん患者のがん検診について
Camelia S Sima1, Katherine S Panageas, Deborah Schrag
1Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, 307 E 63rd St, Second Floor, New York, NY 10065, USA. simac@mskcc.org
JAMA
|October 14, 2010
まとめ
進行した癌の多くの患者は,ほとんど何の利益ももたらさないがんのスクリーニングを受け続けています. この慣習は,これらの個人の寿命が限られているにもかかわらず,継続しており,スクリーニングプロトコルの改訂の必要性を強調しています.
科学分野:
- 腫瘍学 腫瘍学
- 予防医学は,予防的な医療です.
- 医療サービス 研究 医療サービス
背景:
- 癌のスクリーニングは,初等医療の標準的な部分です.
- スクリーニングは,寿命が短い患者に限られた利益をもたらします.
- この研究では,進行がん患者の継続的なスクリーニングを調査しています.
研究 の 目的:
- 進行がんと診断された患者のがん検診の頻度を決定する.
- この患者グループに対してスクリーニング手順が有意義な利益をもたらすかどうかを評価する.
主な方法:
- 65歳以上のMedicare登録者におけるがんスクリーニング (マンモグラフィー,パパニコラウ検査,PSA,下部腸内視鏡検査) の利用率の分析
- 進行した肺がん,大腸がん,臓がん,胃腸がん,乳がんと診断された患者を含む (1998年-2005年).
- がんのない個人のマッチングコホートとの比較.
主要な成果:
- 進行がん患者では,対照群と比較してスクリーニング率が低いことが示されました.
- マンモグラフィー,パパニコラウ検査,PSA,下腸内視鏡検査のスクリーニング率は,進行がん群では著しく低下しました.
- 最近のスクリーニング歴は,診断後のスクリーニングの継続と関連していました.
結論:
- 進行した癌の患者の有意な数は,スクリーニング検査を受けています.
- これらのスクリーニングは,患者の予後を考えると,実質的な臨床的利益をもたらす可能性は低い.
- 進行がん患者の場合,臨床ガイドラインは再評価する必要があるかもしれません.
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