筛查神话

多伦多——乳腺癌筛查一向被看作降低该疾病死亡率的最重要的工具之一。因此,不久前公布的对其有效性的质疑令人震惊——同样令人震惊的还有去年2月发表的加拿大国家乳腺筛查研究25年随访记录。乳腺癌筛查这样有利于疾病早期发现的手段怎么可能没有降低死亡率?

了解筛查在作用上的限制首先需要了解筛查过程。乳腺癌筛查需要对表面健康的人进行乳房X光照射,以检查是否存在未被怀疑的疾病。发现任何异常状况需要进行诊断性实验,确认是否患上了疾病。如果实验结果呈阳性,就需要开始治疗过程。

乳腺癌筛查最重要的限制因素显而易见:没有有效的诊断和治疗手段,筛查起不了多大作用。但这个问题还有更重要的意义——即筛查最终能否降低乳腺癌死亡率。

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