美国PSTF的建议和过度诊断
R Edward Hendrick1, Debra L Monticciolo2
1Department of Radiology, University of Colorado Anschutz School of Medicine, Aurora, CO, USA.
Journal of breast imaging
|June 12, 2024
概括
乳腺癌查中的过度诊断发生在检测到的癌症不会引起症状时. 目前的估计表明过度诊断为10%或更少,主要是由于非进展性病例.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是指放射学
- 预防医学 预防医学
背景情况:
- 癌症查中的过度诊断可以识别出从未在临床上明显的癌症.
- 这种现象可能是由于早期检测缓慢生长或非进展性瘤造成的.
- 准确估计过度诊断是复杂的,需要考虑头时间和瘤进展率.
研究的目的:
- 批判性地评估乳腺癌查中过度诊断的方法和估计.
- 解决当前评估的局限性,特别是美国预防服务工作组 (USPSTF) 的评估.
- 根据现有证据,提出更多可信的过度诊断估计.
主要方法:
- 随机对照试验 (RCT) 和基于人口的查研究数据的审查.
- 对用于估计过度诊断率的建模技术的分析.
- 在USPSTF2024报告中使用的证据来源和建模的批评.
主要成果:
- 由于方法上的挑战,估计过度诊断的估计有很大差异.
- 美国PSTF最近的过度诊断估计受到其证据和建模缺陷的限制.
- 观察性研究表明,乳腺癌查中的过度诊断约为10%或更少.
结论:
- 乳房扫描查中的过度诊断是一种已知的危害,但目前的估计可能被夸大了.
- 强制性过度诊断和局部非进展性导管癌是主要的贡献者.
- 需要更强大的方法来准确评估查计划中的过度诊断.
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