美国癌症中心的皮肤癌查建议:与国家指南不一致
Joyce Lee1, Lynn K Han1, Luc G T Morris2
1Weill Cornell School of Medicine, New York Presbyterian/Weill Cornell Medical Center, New York, NY, USA.
Journal of medical screening
|June 12, 2024
概括
尽管证据不足,但许多美国癌症中心建议进行皮肤癌查. 很少有人讨论过度诊断等危害,强调需要更明确的指导方针和公众对查益处和风险的认识.
科学领域:
- 在瘤学瘤学.
- 皮肤病学 皮肤病学
- 公共卫生 公共卫生
背景情况:
- 在过去的40年里,黑色素瘤的发病率显著上升,但死亡率仍然稳定.
- 这种差异表明,由于广泛的皮肤癌查实践,可能存在过度诊断.
- 美国预防服务工作组 (USPSTF) 目前的指导方针发现,对平均风险成年人进行查的证据不足.
研究的目的:
- 评估美国癌症中心提出的当前皮肤癌查建议.
- 确定这些建议在多大程度上与现有证据保持一致或承认潜在的危害.
主要方法:
- 对来自1113个美国癌症中心的在线皮肤癌查建议进行了审查.
- 记录了推的查年龄,频率,患者人群以及提到证据或危害的数据.
- 这些中心包括由癌症委员会认可的中心,以及国家癌症研究所 (NCI) 指定中心的子集.
主要成果:
- 18%的中心建议对平均风险的成年人进行专业查;35.8%建议自我检查.
- 国家癌症研究所 (NCI) 指定的中心更有可能建议对高风险成年人进行查 (49%对13%).
- 只有0.45%的中心提到查的潜在危害,3.5%特别建议为有色人种进行查.
结论:
- 许多美国癌症中心在没有强有力的支持证据的情况下促进皮肤癌查.
- 查的潜在危害,包括过度诊断,很少被传达给患者.
- 有必要制定基于证据的查指南,并加强公众对查的好处和风险的理解.
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