大人の皮膚がんのスクリーニング:米国予防サービスタスクフォースの最新証拠報告と体系的レビュー
関連する実験動画
Karen J Wernli1, Nora B Henrikson1, Caitlin C Morrison1
1Group Health Research Institute, Kaiser Permanente Research Affiliates Evidence-based Practice Center, Seattle, Washington.
JAMA
|July 27, 2016
まとめ
皮膚がんのスクリーニングが メラノーマの死亡率に 役立つ証拠は限られている. 効果的な皮膚がん検知と予防戦略を 目指す研究が進められるべきです
科学分野:
- 皮膚科
- 予防医学
- 腫瘍学
背景:
- 皮膚がん 特にメラノーマは アメリカにおける 罹病率と死亡率の大きな原因です
- 皮膚がんの臨床スクリーニングは予防的な健康戦略の重要な分野です.
研究 の 目的:
- 米国における成人の皮膚がんスクリーニングを 体系的に検討する.
- 皮膚がん検診の有効性について 予防サービス・タスク・フォースに知らせるため
主な方法:
- MEDLINE,PubMed,Cochraneのデータベースで検索した (1995年−2016年).
- 一般的なリスクのある15歳以上の無症状の個人を対象とした英語の研究が含まれています.
- メラノーマの発生率/死亡率,スクリーニングの害,診断の正確性,およびステージの分布に焦点を当てた.
主要な成果:
- ランダム化臨床試験は行われず,スクリーニングと死亡率に関する証拠は限られている.
- ある生態学的な研究では 集団ベースのスクリーニングにより メラノーマによる死亡が減少することが示唆されました
- 診断の正確さは様々で,皮膚科医は主治医よりも高い感度と特異性を示した.
- 厚いメラノーマの病変と遅い段階の診断は死亡率の増加と関連していました.
結論:
- メラノーマによる死亡率のスクリーニングの利点に関する証拠は限られている.
- 将来の研究は,高リスク集団における標的スクリーニングの有効性を評価すべきである.
- 皮膚がん予防戦略を最適化するためにさらなる研究が必要である.
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