Cancer overdiagnosis: A challenge in the era of screening
作者机构：US National Cancer InstituteDivision of Cancer PreventionBethesdaMarylandUSA MemberThe Lisa Schwartz Foundation for Truth in MedicineNorwichVermontUSA The Center for Medicine in the MediaDartmouth Institute for Health Policy and Clinical PracticeGeisel School of Medicine at DartmouthLebanonNew HampshireUSA DirectorThe Lisa Schwartz Foundation for Truth in MedicineNorwichVermontUSA Beijing Biostar Pharmaceuticals Co.LtdBeijingChina RockvilleMarylandUSA
出 版 物：《Journal of the National Cancer Center》 (癌症科学进展（英文）)
年 卷 期：2022年第2卷第4期
页 面：235-242页
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Cancer overdiagnosis Screening
摘 要：“Screeningis a search for preclinical,asymptomatic disease,including *** cancer screening has led to large increases in early-stage cancers and *** public messages emphasize the potential benefits to screening for these lesions based on the underlying assumption that treating cancer at early stages before spread to other organs should make it easier to treat and cure,using more tolerable *** intuition is so strong that public campaigns are sometimes launched without conducting definitive trials directly comparing screening to usual *** effective cancer screening test should not only increase the incidence of early-stage preclinical disease but should also decrease the incidence of advanced and metastatic cancer,as well as a subsequent decrease in cancer-related ***,screening efforts may be uncovering a reservoir of non-progressive and very slowly progressive lesions that were not destined to cause symptoms or suffering during the person’s remaining natural lifespan:a phenomenon known as“overdiagnosis.We provide here a qualitative review of cancer overdiagnosis and discuss specific examples due to extensive population-based screening,including neuroblastoma,prostate cancer,thyroid cancer,lung cancer,melanoma,and breast *** harms of unnecessary diagnosis and cancer therapy call for a balanced presentation to people considering undergoing screening,even with a test of accepted benefit,with a goal of informed *** also discuss proposed strategies to mitigate the adverse sequelae of overdiagnosis.
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