甲状腺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勧告声明
, Kirsten Bibbins-Domingo1, David C Grossman2
1University of California, San Francisco.
JAMA
|May 12, 2017
まとめ
米国予防サービスタスクフォース (USPSTF) は,無症状の成人の甲状腺がんのスクリーニングを推奨していません. 甲状腺がんの検診の利点は 潜在的害よりも大きいという証拠があります
科学分野:
- 内分泌学
- 腫瘍学
- 予防 医療
背景:
- 甲状腺がんの発生率は著しく上昇していますが 死亡率は変わっていません
- ほとんどの甲状腺がんは 高い生存率で 予後が良好です
研究 の 目的:
- 甲状腺がんのスクリーニングに関する米国予防サービスタスクフォース (USPSTF) の勧告を更新する.
- 無症状の成人を甲状腺がんにスクリーニングする際の利害を評価する.
主な方法:
- スクリーニングの利益と害に関する証拠の体系的な検討
- 頸部パルペーションや超音波などのスクリーニング方法の診断精度の評価
- 甲状腺がんの検査結果の評価
主要な成果:
- スクリーニングの利益に関する直接的な証拠は不十分であり,全体的な利益は小さい可能性が高い.
- 過剰診断と過剰治療を含むスクリーニングと治療による中等から重大な害
- 甲状腺がんのスクリーニングの純利益は負であることが決定されています.
結論:
- USPSTFは,無症状の成人の甲状腺がんのスクリーニングを推奨していません.
- スクリーニングとその後の治療の潜在的な害は,潜在的な益を上回る可能性があります.
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