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乳房X光檢查有優點也有缺點

已有 174 次阅读 2024-7-18 05:01 |个人分类:Health & Health-Care System|系统分类:科普集锦

 译者:“2024 年,該(研究)小組再次表示,所有 40  74 歲之間的女性都應每隔一年進行一次乳房 X 光檢查。”所以,我决定今年不做这个“体罚式的”体检!(之前,我老老实实每年都会去做,虽然疫情中好像没有去。)

 

研究認為,女性可以處理这些細微差別

https://www.npr.org/sections/shots-health-news/2024/07/17/nx-s1-5041985/mammogram-guidelines-breast-cancer-overtreatment

 

新的研究提出了對40 多歲的女性進行教育的理由,讓她們了解檢查的危害和好處。這些女性在長達數十年的爭論中,陷入了是否應該通過乳房光檢查篩檢乳腺癌的爭論。

《內科醫學年鑑》週一發布的一項研究發現,在對39 49 歲之間具有全國代表性的美國女性樣本了解乳房光檢查的利弊後,選擇等到50 歲才接受篩檢的人數是其它选择【译者:也就是在50岁之前】的兩倍多。

大多數女性在進入中年時就已經接受了廣泛傳播的信息,即篩檢乳房X光檢查可以挽救生命。但許多人仍然沒有意識到 40 多歲時常規篩檢的代价——假陽性結果、不必要的活檢、焦慮以及對身体有伤害的)治療,因为这些腫瘤即使不治疗也不會造成任何傷害。【原文:But many remain unaware of the costs of routine screening in their 40s — in false-positive results, unnecessary biopsies, anxiety and debilitating treatment for tumors that left alone would do no harm.】【译者注:Tumor,翻译成腫瘤,包括良性和恶性的。】

 

「在理想的世界中,所有女性都會獲得這些信息,然後讓醫生回答她們進一步的問題,並根據她們的偏好、價值觀和風險水平制定適合她們的篩檢計劃,」社交媒體說心理學家勞拉謝勒(Laura Scherer)是這項研究的主要作者,也是科羅拉多大學醫學院的研究副教授。

在受訪的 495 名女性中,只有 8% 最初表示她們想等到 50 歲才進行乳房 X 光檢查。在研究人員告知这些女性檢查的好處和危害後,18% 的人表示她們會等到 50 歲。

……【译者偷懒了】

新的指南

2024 年,該小組再次表示,所有 40  74 歲之間的女性都應每隔一年進行一次乳房光檢查。年輕女性乳癌發生率不斷上升,以及顯示篩檢可能挽救生命數量的模型,尤其是黑人女性,推動了早期篩檢的推動。

伴随這項新研究的一篇社論強調了乳房X光檢查教育的必要性以及臨床醫生和患者之間共同決策的價值。

安大略省多倫多大學的維多利亞·明特索普洛斯(Victoria Mintsopoulos) 博士和米歇爾·B·納德勒(Michelle B. Nadler) 博士撰寫的社論指出,為了做出明智的決定,過度診斷的危害——定義為對無症狀癌症的診斷,在將來不会傷害患者——必須進行溝通。

 

Mammograms have pros and cons. Women can handle the nuance, study argues

 

https://www.npr.org/sections/shots-health-news/2024/07/17/nx-s1-5041985/mammogram-guidelines-breast-cancer-overtreatment

 

New research makes the case for educating women in their 40s — who've been caught in the crossfire of a decades-long debate about whether to be screened for breast cancer with mammograms — about the harms as well as the benefits of the exam.

After a nationally representative sample of U.S. women between the ages of 39 and 49 learned about the pros and cons of mammography, more than twice as many elected to wait until they turn 50 to get screened, a study released Monday in the Annals of Internal Medicine found. 

 

Most women have absorbed the widely broadcast message that screening mammography saves lives by the time they enter middle age. But many remain unaware of the costs of routine screening in their 40s — in false-positive results, unnecessary biopsies, anxiety and debilitating treatment for tumors that left alone would do no harm.

 

"In an ideal world, all women would get this information and then get to have their further questions answered by their doctor and come up with a screening plan that is right for them given their preferences, their values and their risk level," said social psychologist Laura Scherer, the study's lead author and an associate professor of research at the University of Colorado School of Medicine.

Of 495 women surveyed, only 8% initially said they wanted to wait until they turned 50 to get a mammogram. After researchers informed the women of the benefits and the harms, 18% said they would wait until 50.

New guidelines

In 2024, the panel returned to saying that all women between the ages of 40 and 74 should be screened with mammograms every other year. Rising breast cancer rates in younger women, as well as models showing the number of lives that screening might save, especially among Black women, drove the push for earlier screening.

An editorial accompanying the new study stresses the need for education about mammography and the value of shared decision-making between clinicians and patients.

"For an informed decision to be made," states the editorial written by Dr. Victoria Mintsopoulos and Dr. Michelle B. Nadler, both of the University of Toronto in Ontario, "the harms of overdiagnosis — defined as diagnosis of asymptomatic cancer that would not harm the patient in the future — must be communicated."



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