乳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ためのエビデンスレポートと体系的なレビュー
Jillian T Henderson1, Elizabeth M Webber1, Meghan S Weyrich2
1Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Portland, Oregon.
JAMA
|April 30, 2024
まとめ
現在の乳がん検診の証拠は不確定です. 死亡リスクを減らすための最適なスクリーニング年齢,間隔,方法については,さらなる研究が必要である.
科学分野:
- 腫瘍学
- 放射線科
- 予防 医療
背景:
- 乳がんはアメリカの女性の死亡の主な原因です.
- スクリーニング・マンモグラフィーは死亡リスクを下げますが 最適な戦略は不明です
研究 の 目的:
- 米国予防サービスタスクフォースの異なる乳がんスクリーニング戦略を比較した研究をレビューする.
主な方法:
- ランダム化臨床試験と非ランダム化試験の体系的レビュー
- MEDLINEとコクラン図書館の文献検索は2022年8月まで,監視は2024年3月まで.
- 公正で質の高い研究からデータ抽出と合成
主要な成果:
- 74歳以上の死亡率に関する証拠は限られている.
- デジタル・ブレスト・トモシンセシス (DBT) は,インターバルがんの有意な違いを示さなかったが,リコール率が低かった.
- 補足的なスクリーニング (MRI,超音波) は,偽陽性の増加と混在した結果を示しました.
結論:
- 乳がんのスクリーニング戦略を比較する証拠は不確実です.
- 主要な研究は不完全で,必要な死亡率の結果を報告するものはほとんどありません.
- 最適なスクリーニングガイドラインを確立するには,さらなる研究が必要です.
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