肿瘤的过诊断和过治疗  

Overdiagnosis and overtreatment of cancer

作　　者：郑平菊 师建国[2] 王瑞安[2] 

机构地区：[1]西安市长安医院肿瘤科,陕西西安710016 [2]第四军医大学病理学与病理生理学教研室,陕西西安710032

出　　处：《现代肿瘤医学》2014年第10期2467-2469,共3页Journal of Modern Oncology

基　　金：国家自然科学基金资助项目(编号:30971535)

摘　　要：长期以来,为减少肿瘤的死亡率一直强调"早期诊断和早期治疗"。但迄今病理学并不能够回答多早期的"癌"性病变一定会不可逆的向前发展,恶性生长、转移,直至夺人性命。很多看似"癌"性的病变可长期稳定,甚至消退,在患者因其它原因死亡前不因"癌"而就诊。医学影像技术的进步和医疗福利的提高,很多人群经常进行体检和肿瘤的筛查,从而查出很多早期癌患。本文以乳腺癌、肺癌、前列腺癌和甲状腺癌为例,就这种筛查导致的多诊断出的"癌"和由其导致的不必要的治疗,做一简要回顾分析。“Early diagnosis and early treatment“ has been emphasized for the past few decades as the major strategy to reduce cancer related death. However,so far pathology cannot tell how early is the stagebeyond witchthat“cancer“will irreversibly progress and metastasize till the patient succumb. There are many cancer-likelesions which are sta-ble,or even auto-disappear over the years and will not visit on it. Along with the advancement of imaging technology and the enhancement of medical welfare,increased cancer cases of early cancer are being diagnosed with the physical checkups and cancer screening. We will discuss here the issues of overdiagnosis and overtreatmentcaused by the canc-er screening of breast cancer,lung cancer,prostate cancer,and thyroid cancer.

关 键 词：肿瘤 过诊断 过治疗 过诊癌 筛查 乳腺癌 肺癌 甲状腺癌 原位癌 

分 类 号：R730.5[医药卫生—肿瘤]