卵巢癌查:美国预防服务工作组的最新证据报告和系统审查
Jillian T Henderson1, Elizabeth M Webber1, George F Sawaya2
1Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.
JAMA
|February 17, 2018
概括
在平均风险的妇女中,卵巢癌查没有降低死亡率. 查导致不必要的手术和并发症, 需要进一步的研究才能制定有效的策略.
科学领域:
- 癌症学
- 预防医学
- 临床试验
背景情况:
- 卵巢癌是美国女性癌症死亡的一个罕见但重要的原因.
- 有效的查方法对处于平均风险的妇女来说,对于早期发现和改善结果至关重要.
研究的目的:
- 系统地审查卵巢癌查对平均风险女性的益处和危害的证据.
- 为美国预防服务工作组 (USPSTF) 的建议提供信息.
主要方法:
- 在2003年至2017年间发表的随机临床试验 (RCT) 的系统综述.
- 包括的试验评估了经阴道超声波,癌症抗原125 (CA-125) 测试,或结合方法与常规护理.
- 数据的提取和两个独立的审查员的批判性评估.
主要成果:
- 其中包括4项涉及超过293,000名妇女的RCT.
- 在查和对照组之间没有发现卵巢癌死亡率的显著差异.
- 查导致良性疾病的手术增加,在3-15%的病例中出现重大并发症.
结论:
- 目前的卵巢癌查方法没有显著降低平均风险女性的死亡率.
- 查可能会导致手术并发症和心理困扰.
- 为了制定有效的卵巢癌查和预防策略,需要进一步的研究.
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