诊断审查和癌症风险升高的模式:通过标准化发生率比率揭示过度诊断
Yunchan Chen1, Valeria Gutierrez1, Luc Morris2
1Department of Surgery, Weill Cornell Medicine, New York, USA.
Cureus
|August 28, 2023
概括
调查癌症风险增加揭示了可以区分真实的致癌性暴露与由于医疗监测增加而导致过度诊断的模式. 分析风险分布有助于确定导致检测惰性瘤的因素.
科学领域:
- 流行病学 流行病学
- 在瘤学瘤学.
- 医学诊断 医学诊断 医学诊断
背景情况:
- 医学诊断和暴露可以通过因果关系或增加检测 (过度诊断) 来提高癌症风险.
- 区分这些机制对于准确的风险评估至关重要.
研究的目的:
- 调查与各种诊断和暴露相关的癌症风险升高的分布模式.
- 要区分致癌过程和加强诊断审查.
主要方法:
- 对过去30年的研究进行系统的文献搜索,检查标准化发病率 (SIR).
- 计算不同类型癌症的元SIR.
- 在过度诊断易感和非易感癌症之间风险分布的比较.
主要成果:
- 确定了四种不同的SIRs升高模式.
- 模式因癌症类型的过度诊断易感性和暴露的性质而有所不同.
- 一些风险因素与特定的癌症类型有关,而另一些风险因素没有明显增加.
结论:
- 增加癌症风险分布的模式可以作为潜在机制的签名.
- 这种分析有助于识别那些看起来是癌症风险因素,但由于医疗监测和过度诊断而导致的疾病.
- 增加癌症风险应谨慎解释,考虑到潜在的过度诊断.
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