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在晚期癌症患者中进行癌症查
Camelia S Sima1, Katherine S Panageas, Deborah Schrag
1Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, 307 E 63rd St, Second Floor, New York, NY 10065, USA. simac@mskcc.org
JAMA
|October 14, 2010
概括
许多患有晚期癌症的患者继续接受癌症查,但几乎没有任何益处. 尽管这些人的预期寿命有限,但这种做法仍然存在,这凸显了需要修订查协议的需要.
科学领域:
- 在瘤学瘤学.
- 预防医学 预防医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 癌症查是初级保健的标准部分.
- 查对预期寿命短的患者提供了有限的益处.
- 这项研究调查了晚期癌症患者的持续查.
研究的目的:
- 确定诊断为晚期癌症的患者进行癌症查的频率.
- 评估查程序是否为这个患者群体提供有意义的益处.
主要方法:
- 在65岁以上的医疗保险注册人群中分析癌症查利用率 (乳房录像,帕帕尼科劳试验,PSA,下部肠道内镜).
- 包括诊断为晚期肺癌,结肠直肠癌,胰腺癌,胃食道癌或乳腺癌的患者 (1998-2005).
- 与没有癌症的匹配群体进行比较.
主要成果:
- 与对照组相比,晚期癌症患者的查率较低.
- 在晚期癌症组中,乳房影像,帕帕尼科劳试验,PSA和下部肠道内镜的查率明显较低.
- 最近的查史与诊断后的持续查有关.
结论:
- 许多患有晚期癌症的患者接受查测试.
- 鉴于患者的预后,这些查不太可能提供实质性的临床益处.
- 临床指南可能需要对晚期癌症患者进行重新评估.
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