秒速赛车控制器

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ACS:2015 乳腺癌篩查指南解讀
發布時間: 2015-11-26     來源: 丁香園

 哈佛醫學院衛生保健政策部門的 Keating 教授在 JAMA 發布了對美國女性乳腺癌篩查的最新指南的分析。


秒速赛车控制器 盡管對于乳腺癌篩查的關注度和投入都很高,但鉬靶篩查的利弊以及如何選擇合適的人群進行篩查和篩查策略仍然是個難題。上一版乳腺癌篩查指南制定于 2003 年,美國腫瘤協會(ACS)日前對其進行了更新。

新舊指南對比

ZAI 2003 BANDEYIJIANZHONG,ACS TUIJIANSUOYOUNVXINGCONG 40 SUIKAISHIMEINIANJINXINGMUBASHAICHA,20-40 SUIDENVXINGDINGQIJINXINGLINCHUANGRUFANGJIANCHA(CBE),ER 40 SUIJIYISHANGDENVXINGYINGMEINIANXING CBE。

秒速赛车控制器XINBANZHINANZEQIANGDIAOPINGJUNFENGXIANNVXINGDESHAICHA,TUIJIAN 45 ZHI 54 SUINVXINGMEINIANXINGMUBAJIANCHA,55 SUIJIYISHANGNVXINGMEILIANGNIANJINXING 1 CIMUBAJIANCHA,ZHIZHIYUQISHOUMINGBUZU 10 NIAN,BUTUIJIANRENHENVXINGJINXINGCHANGGUI CBE。

新版指南解讀

秒速赛车控制器XINBANZHINANZHONGZHIDEZHUYIDEJIGEFANGMIAN:

(1)KAISHIMUBASHAICHADESHIJIANCONG 40 SUITUICHIZHI 45 SUI,GENGJIEJINMEIGUOYUFANGYIXUEGONGZUOZU(USPSTF)ZHIDINGDEZHINAN;

(2)TUIJIAN 45 ZHI 54 SUINVXINGJINXINGGENGPINFANDENIANDUSHAICHA;

秒速赛车控制器(3)BUTUIJIANCHANGGUI CBE,ZHEDIANHEZHIQIANDEZHINANJIERANBUTONGBINGQIEBI USPSTF DECUOCIGENGQIANGYING,USPSTF ZHINANZHONGJINSHUOMINGMEIYOUCHONGZUDEZHENGJUTUIJIANHUOFANDUI CBE;

秒速赛车控制器(4)YUQISHOUMINGBUZU 10 NIANSHIJIANYITINGZHISHAICHA,USPSTF JINSHUOMINGMEIYOUCHONGZUDEZHENGJUZHICHI 75 SUIJIYISHANGDENVXINGSHAICHADELIHUOBI。

XINBANZHINANDEZUOZHE Oeffinger JIAOSHOUTUANDUIYIJIJINXINGZHENGJUSHENCHADE Myers JIAOSHOUTUANDUIZUOCHULESHUZHONGFANGFAXUEDEJUECECAIDECHUXINDEJIANYI:

SHOUXIAN,Oeffinger JIAOSHOUTUANDUIZONGSHUGUANGFANFENXILEJINNIANLAIPINGGUMUBADEGUANCHAXINGYANJIU,ZHEWEIYUCEMUBASHAICHAYURUXIANAISIWANGXIANGDUIFENGXIANJIANGDIDEGUANXITIGONGLEHENDADEFANWEI。GUANCHAXINGYANJIUXIANSHI 40 SUIYISHANGNVXINGJINXINGMUBASHAICHANENGJIANGDISIWANGFENGXIAN 20%-40%,ERSUIJISHIYANZEXIANSHIJINJIANGDI 15% DEFENGXIAN。

Oeffinger JIAOSHOUTUANDUICHENGRENGUANCHAXINGYANJIUJUYOUJUXIANXING,BAOKUOQIANZAIDEBUKEBIDEDUIZHAOZU,LINGXIANSHIJIANPIANYIHEBINGCHENGPIANYI,YIJICONGZHENDUANHEZHILIAODEBIANHUAZHONGFENBIANSHAICHAYINGXIANGDETIAOZHAN。YICITONGSHI,TAMENYEZHICHULEXIANYOUSUIJISHIYANDEQUEXIAN,RUMUBABAOLUBUYIZHIYIJIYIXIEFAXIANZHUJIANLUOWU。

秒速赛车控制器QICI,Oeffinger JIAOSHOUTUANDUIBINGQICHUANTONGPINGGUMUBALIBICAIYONG 10 NIANDENIANLINGFENZU,GAIWEI 5 NIANNIANLINGFENGEDEJIANCE、LIUXINGBINGXUEJIZHONGDIANJIEGUODESHUJUMIAOSHURUXIANAIFUDAN,CONGERFAXIANRUXIANAISIWANGDEJUEDUIFENGXIANYUFENBUZAI 45-49 SUIYU 50-54 SUIBI 40-44 SUIGENGXIANGSI。

DISAN,Oeffinger JIAOSHOUTUANDUICAINALERUXIANAIJIANCEXIEHUI(BCSC)PINGGUMEINIANHEMEILIANGNIANSHAICHADEJIEGUO。BCSC DEYANJIUBIJIAOLE 1996 ZHI 2012 NIAN 15440 WEI 40-85 SUIDERUXIANAIHUANZHEMEINIANSHAICHAHEMEILIANGNIANSHAICHADEXIAOGUO,JIEGUOXIANSHIJUEJINGQIANNVXINGMEINIANSHAICHAGENGYOUZHUYUAIZHENGYUFANG,ERJUEJINGHOUNVXINGZEWUXIANZHUCHAYI。JINGUANGENGRONGYIFASHENGGENGJUQINXIXINGZHONGLIUDENIANQINGNVXINGKENENGCONGPINFANSHAICHAZHONGHUOYI,DANSHIJIDELINCHUANGXIAOGUOSHANGBUQUEDING。MEINIANMUBAJIANCHAYEYOUBIDUAN,RUKENENGZAOCHENGGENGDUODEJIAYANGXINGJIEGUOYIJIBUBIYAODEHUOJIAN。

ZUIHOU,YESHIBIANDONGZUIDADEDIFANGSHI,XINBANZHINANBUTUIJIANCHANGGUI CBE,MUQIANMEIYOUSHIYANZHIJIEPINGGU CBE DUIRUXIANAISIWANGLVDEYINGXIANG,JIQUEFACHONGFENDEZHENGJUZHICHI CBE。JIYUMEIGUORENQUNDEDUILIEYANJIUXIANSHIMUBAZHIWAIJINXING CBE ZAI 1000 GENVXINGZHONGJINNENGDUOFAXIAN 0.4 GEAIZHENG,QUEDAILAILE 20.7 GEJIAYANGXING,YINCIXIANZHI CBE SHIHELIDE。

臨床建議

秒速赛车控制器ACS ZHINANYU USPSTF ZHINANSHIMUQIANZHUYAODE 2 GEZHINAN,GENGXINHOUDE ACS ZHINANYU USPSTF ZHINANGENGYIZHI,LIANGZHEDOURENTONG 45 SUIYIXIANVXINGMUBASHAICHABIDAYULI,ER 55 SUIYISHANGNVXINGYINGMEILIANGNIANMUBASHAICHA。BUTONGDESHI,ACS JIANYI 45-54 SUINVXINGMEINIANSHAICHA,ER USPSTF BUJIANYI 45-49 SUINVXINGCHANGGUISHAICHA,QIEJIANYI 50-54 SUINVXINGMEILIANGNIANSHAICHA。

YISHENGXUGENJUHUANZHEDEJUTIQINGKUANGZONGHEKAOLIANGGEICHUHESHIDESHAICHAJIANYI,ZAIGEICHUJIANYIQIANYOUJIDIANZHIDECANKAO:

1. JUEDADUOSHURUXIANAIHUANZHEYUHOUBUSHOUMUBASHAICHAYINGXIANG。YANJIUXIANSHIMUBAJIANCHANENGGOUJIANSHAO 15% DE 40-60 SUIRUXIANAIHUANZHESIWANG,HUANYANZHI 85% DE 40-60 SUIRUXIANAIHUANZHEBUHUICONGMUBASHAICHAZHONGHUOYI。

2. DUIYUPINGJUNFENGXIANDENVXING,JUEDINGCHANGGUIMUBASHAICHASHIBIXUKAOLVDAOMUBASHAICHADEFENGXIAN,RUGUODUZHENDUANDEKENENGXINGJIXIANGGUANDEGUODUZHILIAO,HUANYOUJIAYANGXINGDEFENGXIANHEBUBIYAODEHUOJIAN。

秒速赛车控制器3. SHIFOUJINXINGMUBASHAICHAYIJISHAICHAPINLVYINGGENJUHUANZHEDERUXIANAILIHUANFENGXIANJUEDING。

JINGUANYOUDALIANGGUANYUMUBASHAICHADEWENXIAN,DANMUQIANDEZHENGJURENGBUZUYIBANGZHUNVXINGJUEDINGSHIFOUCAIYONGMUBASHAICHAYIJISHAICHADECELVE。WEILAIRUXIANAISHAICHAXUYAOGENGDUOGETIHUADERUXIANAIFENGXIANXINXI,ZHEYOULAIYUYIYOUDEFENGXIANPINGGUGONGJUYIJIJIYINZUXUEDENGXINJISHUDEYINGYONG。SHIBIERUXIANAILIHUANGAOFENGXIANRENQUN,KEYIGENGYOUZHENDUIXINGDIQUEDINGXUYAOSHAICHADERENQUNBINGXUANZEXINGDIJINXINGGAOPINSHAICHA,CONGERZUIDACHENGDUXIANZHISHAICHADEBIDUAN。