皮肤癌查:美国预防服务工作组建议声明
, Kirsten Bibbins-Domingo1, David C Grossman2
1University of California, San Francisco.
JAMA
|July 27, 2016
概括
目前的证据不足以确定临床医生的视觉皮肤检查是否有效地选成人皮肤癌. 需要更多的研究来平衡潜在的好处与不必要的活检和过度诊断等危害.
科学领域:
- 皮肤病学
- 预防医学
- 癌症学
背景情况:
- 黑色素瘤的死亡率高于基底细胞癌和状细胞癌.
- 在2016年,估计有76,400名美国人患上黑色素瘤,其中10,100人死亡.
- 美国预防服务工作组 (USPSTF) 在2009年发布了建议.
研究的目的:
- 提供基于证据的关于2009年USPSTF关于皮肤癌查的建议.
- 评估临床视觉皮肤检查在减少皮肤癌发病率和死亡率方面的有效性.
主要方法:
- 对皮肤癌查视觉皮肤检查的证据进行系统审查.
- 与常规护理相比,对查的有效性,潜在的危害,测试特征和早期检测的评估.
- 包括对初级保健医生和皮肤科医生的研究.
主要成果:
- 对视觉皮肤检查降低黑色素瘤发病率和死亡率的有效性有有限的直接证据.
- 关于危害的信息,如不必要的活检和过度诊断,很少,但潜在的危害得到了认可.
- 现有证据的质量,包括一个关键的生态研究,具有显著的方法限制.
结论:
- 目前的证据不足以评估临床医生对成年人皮肤癌查的视觉皮肤检查的益处和危害.
- 一个"I"声明表明没有足够的证据来推或反对查.
- 需要进一步的研究来澄清皮肤癌查的净益.
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