高リスクヒトパピローマウイルス検査による子宮頸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
Joy Melnikow1, Jillian T Henderson2, Brittany U Burda2
1University of California, Davis, Center for Healthcare Policy and Research, Sacramento.
JAMA
|August 25, 2018
まとめ
高リスクヒトパピロマウイルス (hrHPV) のスクリーニングでは,がん前の子宮頸細胞の変化がより多く検出されるが,偽陽性症例は増加する. hrHPVスクリーニングは,細胞検査のみと比較して侵襲性子宮頸がんのリスクを軽減します.
科学分野:
- 婦人科
- 腫瘍学
- 公衆衛生
背景:
- 子宮頸がんは,がん前疾患の早期発見と治療によって予防できます.
- 高リスクヒトパピローマウイルス (hrHPV) は 子宮頸がんの90%以上の原因です
研究 の 目的:
- 子宮頸がんに対する hrHPVスクリーニングの利害を体系的に検討する.
- 予防サービス・タスク・フォースのガイドラインを報告する.
主な方法:
- ランダム化臨床試験とコホート研究の体系的レビュー
- 2011年から2018年までMEDLINE,PubMed,PsycINFO,Cochrane Libraryで検索しました
- 8つのRCT,5つのコホート研究,1つのメタ解析からのデータの質的合成.
主要な成果:
- プライマリ hrHPVスクリーニングでは,細胞検査と比較して,CIN 3+の検出が増加しました.
- CIN3+の初期検出は認められなかったが,侵襲性子宮頸がんのリスクは減少した.
- 両方 hrHPV 戦略は,細胞学よりも高い偽陽性およびコルポスコピー率を示しました.
結論:
- 主要なHRHPVスクリーニングは,がん前変化を検出するのに有効です.
- hrHPVスクリーニングで誤った陽性の割合が高くなる場合,治療の増加と潜在的な害につながる可能性があります.
- hrHPVスクリーニング戦略は,侵襲性子宮頸がんの発生率を減少させるのに有望である.
関連する概念動画
01:30Preventive Healthcare Services
2.2K
Preventive healthcare services keep people healthy via frequent check-ups, screening, and counseling. They primarily aid in disease prevention rather than treating an acute or chronic illness. Preventive treatment also keeps individuals productive and energetic, allowing them to work well into their retirement years. Examples of preventive care services include:
2.2K
02:59Cancer Prevention
8.1K
Several factors can increase the risk of cancer in an individual. About 50% of cancer cases can be prevented by adopting a healthy lifestyle, regular exercise, eating healthy, and following a modest cancer prevention diet. Epidemiological studies have consistently shown that populations with vegetable and fruit-rich diets have reduced the incidence of cancer. On the other hand, populations who have a diet rich in animal fat, red meat, junk food, or high calories are predisposed to cancer.
Some...
Some...
8.1K
02:55The Evidence for Evolution
48.3K
Genetic variations accumulating within populations over generations give rise to biological evolution. Evolutionary changes can result in the formation of novel varieties and entire new species. These changes are responsible for the diverse forms of life inhabiting the planet. The evidence for evolution suggests that all living organisms descended from common ancestors.
48.3K
01:22Self-Report Tests of Personality
871
Self-report inventories are objective personality assessments that use multiple-choice items or numbered scales, typically ranging from 1 (strongly disagree) to 5 (strongly agree). They are often called Likert scales after Rensis Likert. These inventories are widely used due to their ease of administration and cost-effectiveness. One of the most prominent examples is the Minnesota Multiphasic Personality Inventory (MMPI), initially developed in the 1940s to assess abnormal personality traits.
871
01:10Review and Preview
8.4K
In statistics, several tools are used to interpret the data. Measures of central tendency represent the characteristics of the data, such as mean, median, and mode. Additionally, measures of variance like standard deviation and range are used to find the spread of data from the mean. Relative standing measures the distance between data locations. Commonly used measures of relative standings are percentile, z score, and quartiles.
Percentiles are a type of fractile that partition data into...
Percentiles are a type of fractile that partition data into...
8.4K
01:13Review and Preview
11.5K
Data are individual items of information obtained from a population or sample. Data may be classified as qualitative (categorical), quantitative continuous, or quantitative discrete. Because it is not practical to measure the entire population in a study, researchers use samples to represent the population. A random sample is a representative group from the population chosen by using a method that gives each individual in the population an equal chance of being included in the sample. Random...
11.5K