乳腺X线筛查乳腺癌引起过度诊断的研究进展  

Overdiagnosis in mammography screening for breast cancer

作　　者：黄育北 杨雷[2] 宋丰举 陈可欣 

机构地区：[1]天津医科大学肿瘤医院流行病室天津市肿瘤防治重点实验室乳腺癌防治教育部重点实验室国家肿瘤临床医学研究中心,300060 [2]北京大学肿瘤医院肿瘤研究所北京市肿瘤防治办公室,100142

出　　处：《中华流行病学杂志》2017年第11期1574-1578,共5页Chinese Journal of Epidemiology

基　　金：国家科技支撑计划（2014BA109809,2015BA112815）;国家自然科学基金（81502476）

摘　　要：筛查历来就是一把双刃剑。癌症筛查在给部分人带来收益的同时，也会给另一部分人带来过度诊断。过度诊断是对永远不会导致症状出现或威胁生命的癌症的诊断，由此可能造成被诊断者接受不必要的治疗及终身监测，进而造成不必要的经济负担以及身体和心理上的损害。如何正确评价过度诊断，以及如何根据过度诊断产生的原因，采取有针对性的措施来减少或避免过度诊断，将是乳腺癌筛查中需要深度思考的问题。本文在系统总结既往相关研究的基础上，详细阐述乳腺x线筛查乳腺癌引起过度诊断产生的原因、评价方法，以及避免过度诊断可采取的措施。Screening has been always considered as a double-edged sword. Cancer screening could save lives in some cases, however, in other cases, it might also turn people into overdiagnosis. Overdiagnosis is the diagnosis of cancer that will never cause symptoms or death during a patient＇ s lifetime. Therefore, overdiagnosis might lead to unnecessary treatments and lifetime surveillance, and then increase economic burden and psychological burden. In this review, we focus on how to correctly evaluate the overdiagnosis rate, and how to avoid or reduce the harms caused by overdiagnosis in the future according to the reasons associated with overdiagnosis. After systematically reviewing the previous studies, we will try to identify the potential reasons associated with overdiagnosis in breast cancer screening with mammography, address how to correctly evaluate the overdiagnosis rate, and finally provide some suggestions to reduce the overdiagnosis.

关 键 词：乳腺癌 筛查 过度诊断 

分 类 号：R737.9[医药卫生—肿瘤]