Cancer screening in theory and in practice

被引:64
作者
Brawley, OW
Kramer, BS
机构
[1] Emory Univ, Winship Canc Inst, Atlanta, GA USA
[2] NIH, Bethesda, MD 20892 USA
关键词
D O I
10.1200/JCO.2005.06.107
中图分类号
R73 [肿瘤学];
学科分类号
100214 [肿瘤学];
摘要
Improvements in technology have led to a number of tests that can be used to suggest that a patient has a cancer. Advances in cancer biology and medical imaging have led to a number of cancer screening tests. Cancer screening is commonly advocated, but its complexity is often lost in guidelines that have sound-bite quality. It is commonly viewed as of no harm. when in fact there are harms associated with every known screening test. Indeed, many screening experts believe a screening test should only be used when the potential for benefit clearly outweighs the potential for harm. Cancer screening principles are classically within the realm of the epidemiologist. As more screening tests are developed, these principles have become more relevent to the pacticing clinician. What is known and what is unknown about screening is distincilly distinctly from what is believed by the public and many practicing clinicians. Many tests have both screening and diagnostic uses, and it is only the context in which these are used that determines whether they are screening or diagnostic. A screening test is done on asymptomatic individuals who receive the test principally because they are oil the age or sex at risk for the cancer. A diagnostic test is done on an individual because of clinical suspicion of disease.
引用
收藏
页码:293 / 300
页数:8
相关论文
共 47 条
[1]
HEMOCCULT SCREENING IN DETECTING COLORECTAL NEOPLASM - SENSITIVITY, SPECIFICITY, AND PREDICTIVE VALUE - LONG-TERM FOLLOW-UP IN A LARGE GROUP-PRACTICE SETTING [J].
ALLISON, JE ;
FELDMAN, R ;
TEKAWA, IS .
ANNALS OF INTERNAL MEDICINE, 1990, 112 (05) :328-333
[2]
Ault MJ, 2000, NEW ENGL J MED, V343, P1652
[3]
BARRY H, 2003, AM FAM PHYSICIAN, V67, P1784
[4]
THE POTENTIAL ROLE OF SERUM CA-125 IN AN ULTRASOUND-BASED SCREENING-PROGRAM FOR FAMILIAL OVARIAN-CANCER [J].
BOURNE, TH ;
CAMPBELL, S ;
REYNOLDS, K ;
HAMPSON, J ;
BHATT, L ;
CRAYFORD, TJB ;
WHITEHEAD, MI ;
COLLINS, WP .
GYNECOLOGIC ONCOLOGY, 1994, 52 (03) :379-385
[5]
Brisson J, 2000, CANCER EPIDEM BIOMAR, V9, P911
[6]
Computed tomographic colonography (virtual colonoscopy) - A multicenter comparison with standard colonoscopy for detection of colorectal neoplasia [J].
Cotton, PB ;
Durkalski, VL ;
Benoit, PC ;
Palesch, YY ;
Mauldin, PD ;
Hoffman, B ;
Vining, DJ ;
Small, WC ;
Affronti, J ;
Rex, D ;
Kopecky, KK ;
Ackerman, S ;
Burdick, JS ;
Brewington, C ;
Turner, MA ;
Zfass, A ;
Wright, AR ;
Iyer, RB ;
Lynch, P ;
Sivak, MV ;
Butler, H .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 291 (14) :1713-1719
[7]
SCREENING FOR COLORECTAL-CANCER [J].
EDDY, DM .
ANNALS OF INTERNAL MEDICINE, 1990, 113 (05) :373-384
[8]
Ten-year risk of false positive screening mammograms and clinical breast examinations [J].
Elmore, G ;
Barton, MB ;
Moceri, VM ;
Polk, S ;
Arena, PJ ;
Fletcher, SW .
NEW ENGLAND JOURNAL OF MEDICINE, 1998, 338 (16) :1089-1096
[9]
Etzioni R, 2002, J NATL CANCER I, V94, P981
[10]
REPORT OF THE INTERNATIONAL WORKSHOP ON SCREENING FOR BREAST-CANCER [J].
FLETCHER, SW ;
BLACK, W ;
HARRIS, R ;
RIMER, BK ;
SHAPIRO, S .
JOURNAL OF THE NATIONAL CANCER INSTITUTE, 1993, 85 (20) :1644-1656