癌症查,偶然检测和过度诊断
H Gilbert Welch1, Regan Bergmark1
1Center for Surgery & Public Health, Department of Surgery, Brigham and Women's Hospital, Boston, MA, United States.
Clinical chemistry
|September 27, 2023
概括
通过查早期发现癌症可能导致过度诊断,在这种情况下,可以识别无症状的癌症,而不是注定会造成伤害. 这挑战了早期诊断总是等同于更好的结果的假设.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 医学诊断 医学诊断 医学诊断
背景情况:
- 从历史上看,癌症诊断依赖于症状表现.
- 现代查和偶然检测可以识别无症状癌症.
- 这导致过度诊断:检测癌症不太可能引起症状或死亡.
结论:
- 早期诊断是普遍优越的说法需要重新评估.
- 瘤生物学和宿主反应是关键的预后因素,可能比检测时间更重要.
- 挑战"更早总是更好"的范式是必要的.
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