甲状腺癌查:美国预防服务工作组的最新证据报告和系统审查
Jennifer S Lin1, Erin J Aiello Bowles2, Selvi B Williams1
1Kaiser Permanente Center for Health Research, Kaiser Permanente Research Affiliates Evidence-based Practice Center, Portland, Oregon.
JAMA
|May 12, 2017
概括
虽然甲状腺癌查可以发现病例, 但缺乏证据证明它可以降低死亡率. 过度诊断和治疗的危害是对无症状成年人的查的潜在风险.
科学领域:
- 癌症学
- 预防医学
- 诊断的准确性
背景情况:
- 美国的甲状腺癌发病率正在上升.
- 大多数甲状腺癌的预后都很好.
研究的目的:
- 审查无症状成年人甲状腺癌查和早期治疗的益处和危害.
- 通知美国预防服务工作组.
主要方法:
- 对MEDLINE,PubMed和Cochrane图书馆 (1966-2016) 的系统审查.
- 包括对无症状成年人的英语研究.
- 分析了手术的危害.
主要成果:
- 没有研究直接表明查有好处.
- 部触摸缺乏对结节的敏感性.
- 高危的超声波特征显示为恶性瘤的特异性.
- 查和精细针吸入没有严重的危害.
- 手术的危害包括甲状腺功能低下和神经.
- 放射性治疗增加了二次恶性瘤和口腔干燥的风险.
结论:
- 目前尚不清楚查是否会降低甲状腺癌的死亡率或改善结果.
- 查可能导致过度诊断惰性癌症.
- 过度诊断和随后的治疗可能会对患者造成伤害.
相关概念视频
02:59Cancer Prevention
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...
02:59Cancer Prevention
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...
01:21Cancer Survival Analysis
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...