臓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
Nora B Henrikson1, Erin J Aiello Bowles1, Paula R Blasi1
1Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Research Affiliates Evidence-based Practice Center, Seattle.
JAMA
|August 7, 2019
まとめ
画像を用いた高リスク患者の臓がんのスクリーニングは,最小限の害で病気を検出することができます. しかし,生存率と治療の有効性に対するスクリーニングの影響は,これらのグループではまだ研究されていません.
科学分野:
- 腫瘍学
- 予防 医療
- 診断用イメージング
背景:
- 臓腺がんは米国で がんによる死亡の主な原因です
- 効果的なスクリーニング戦略は 患者の治療結果を改善するために必要です
研究 の 目的:
- 臓腺がんのスクリーニングの利害を体系的に検討する.
- 米国予防サービスタスクフォース (USPSTF) の勧告を参考にすること.
主な方法:
- MEDLINE,PubMed,およびコクラン図書館の体系的なレビュー (2002年−2019年)
- リスク因子を含む成人の画像ベースのスクリーニング試験を含む.
- 遺伝的症候群に関する研究を除外した.
主要な成果:
- 高リスクの家族集団における,適正な品質のコホート研究13件 (N=1317) が含まれた.
- スクリーニングでは,内視超音波,MRI,CTで1000人あたり0~75人の症例が示されました.
- 罹患率/死亡率や治療の有効性に対するスクリーニングの影響に関する研究は報告されていません.
- 最小限の手続き的および心理的害が報告されました.
結論:
- 画像ベースのスクリーニングは,低リスクの高リスクグループで臓がんを検出できます.
- 生存に対するスクリーニングの影響に関する証拠は不足している.
- 平均リスク集団と治療の有効性に関するデータは不十分です.
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