有关乳腺癌群体筛查若干问题的思考

发布时间：2018-03-01 20:40

本文关键词： 乳腺癌群体性筛查钼靶X线机会性筛查　出处：《医学与哲学(B)》2017年01期 　论文类型：期刊论文

【摘要】：乳腺癌是全球女性恶性肿瘤发病率最高的疾病,对适龄妇女进行群体性的乳腺癌筛查旨在早发现、早诊断、早治疗,从而有效降低乳腺癌的死亡率。欧美国家于数十余年前开始全国范围的乳腺癌的群体筛查,早期的观察性研究认为筛查能独立降低乳腺癌的死亡率,而近期的许多群体研究结果却不断对钼靶筛查的获益提出质疑。中国对肿瘤的筛查早已有之,包括乳腺癌在各地区的群体性筛查也开展多年,但尚无一个权威性的研究结论供我们参考。笔者借鉴国内外的相关研究结果和自己在临床工作中的机会性筛查体会,对中国乳腺癌筛查的相关问题进行了思考,提出群体性的钼靶筛查并不适合中国国情,不应予以提倡和推广。应当建立符合中国乳腺癌发病特征的风险评估模型,根据风险评估结果,有针对性地对高危女性进行重点筛查,结合机会性筛查,采取临床触诊、彩超和钼靶相互结合为主的筛查方法,才是适合中国国情的乳腺癌筛查之道。
[Abstract]:Breast cancer is the disease with the highest incidence of malignant tumors in women in the world. Screening for breast cancer among women of appropriate age aims at early detection, early diagnosis and early treatment. In order to effectively reduce the mortality rate of breast cancer, European and American countries began nationwide breast cancer screening more than a few decades ago. Early observational studies suggested that screening can independently reduce breast cancer mortality. Many recent studies have questioned the benefits of mammography screening, which has long been available in China, including mass screening for breast cancer in various regions for many years. However, there is not an authoritative conclusion for our reference. The author, referring to the relevant research results at home and abroad and his own experience of opportunistic screening in clinical work, thinks about the relevant problems of breast cancer screening in China. It is suggested that mass mammography screening is not suitable for China's national conditions and should not be promoted and popularized. A risk assessment model should be established in accordance with the characteristics of breast cancer incidence in China, and according to the risk assessment results, Targeted screening of high-risk women, combined with opportunistic screening, clinical palpation, color ultrasound and molybdenum target, is the best way to screen breast cancer in China.
【作者单位】：湖南省人民医院(湖南师范大学第一附属医院)乳甲外科;
【分类号】：R737.9

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