Версия для печати темы
Нажмите сюда для просмотра этой темы в оригинальном формате |
Фармакологические форумы > Мастопатия: www.mastopatia.ru > Regular self-examination or clinical examination for early detection of breast cancer |
Автор: ChinaDoc 13.09.2008 - 00:23 |
Cochrane Copyright © 2008 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. DOI: 10.1002/14651858.CD003373 This version first published : 22 April 2003 in Issue 2, 2003. Last assessed as up-to-date: 8 October 2007. (Dates and statuses?) of Reviews, Issue 3, 2008 (Status in this issue: New search for studies completed, conclusions not changed) This record should be cited as: Kösters JP, Gøtzsche PC. Regular self-examination or clinical examination for early detection of cancer. Cochrane of Reviews 2003, Issue 2. Art. No.: CD003373. DOI: 10.1002/14651858.CD003373. Abstract Background Breast self-examination and clinical
breast examination have been promoted for many years as general screening
methods to diagnose cancer at an early stage in order to decrease
morbidity and mortality. The possible benefits and harms remain unclear.Objectives To determine whether screening for
breast cancer by regular self-examination or clinical examination reduces
breast cancer mortality and morbidity.Search strategy For this update, the Cochrane
Breast Cancer Group Specialised Register, The Cochrane Library and PubMed
were searched (October 2007).Selection criteria Randomised clinical trials,
including cluster randomised trials.Data collection and analysis Decisions on which
trials to include were taken independently by the authors based on the methods
of a trial. Disagreements were resolved by discussion. Intention-to-treat
analyses were conducted using a fixed-effect model with 95% confidence
intervals.Main results Two large population-based studies
(388,535 women) from Russia and Shanghai that compared self-examination
with no intervention were included. There was no statistically significant
difference in cancer mortality between the groups (relative risk 1.05,
95% confidence interval (CI) 0.90 to 1.24; 587 deaths in total). In Russia, more
cancers were found in the self-examination group than in the control
group (relative risk 1.24, 95% CI 1.09 to 1.41) while this was not the case in
Shanghai (relative risk 0.97, 95% CI 0.88 to 1.06). Almost twice as many
biopsies (3406) with benign results were performed in the screening groups
compared to the control groups (1856) (relative risk 1.88, 95% CI 1.77 to 1.99).
One large population-based trial of clinical examination combined with
breast self-examination was also included. The intervention was discontinued
because of poor compliance with follow up and no conclusions could be
drawn.Authors' conclusions Data from two large trials do
not suggest a beneficial effect of screening by self-examination but do
suggest increased harm in terms of increased numbers of benign lesions
identified and an increased number of biopsies performed. At present, screening
by self-examination or physical examination cannot be recommended.Plain language summary Regular self-examination or clinical examination for early detection of cancer. Breast cancer is a common cause of cancer morbidity and mortality in women. self-examination (examination of the s by the individual) or clinical breast examination (examination of the s by a doctor or a nurse) have been promoted for many years as screening methods to diagnose cancer at an early stage, in order to decrease the risk of dying from cancer. This review searched for well-designed trials that assessed these methods and found two large population-based studies involving 388,535 women who compared self-examination with no intervention. The review of data from these trials did not find a beneficial effect of screening in terms of improvement in cancer mortality. The trials showed that women who were randomised to self-examination were almost twice as likely to undergo a biopsy of the , with 3406 biopsies performed in the screening group compared to 1856 biopsies in the control group. The only large population-based trial of clinical examination combined with self-examination that was identified was discontinued. This was because of poor compliance with follow up and no conclusions can be drawn from the study. Some women will continue with breast self-examination or will wish to be taught the technique. We suggest that the lack of supporting evidence from the two major studies should be discussed with these women to enable them to make an informed decision. Women should, however, be aware of any changes. It is possible that increased awareness may have contributed to the decrease in mortality from cancer that has been noted in some countries. Women should, therefore, be encouraged to seek medical advice if they detect any change in their s that may be breast cancer. © The Cochrane Library |
Автор: Джина 15.09.2008 - 09:31 |
"...The review of data from these trials did not find a beneficial effect of screening in terms of improvement in А кто бы еще занялся исследованием отрицательных моментов массированного насаждения самоосмотров и и клинического скрининга (тут упомянуто только количество избыточных биопсий с благоприятными результатами). приобрела уже характер эпидемии! Гонят женщин на скрининговую маммографию, а много ли есть на перифрии врачей, УМЕЮЩИХ читать маммограммы!? "Women should, however, be aware of any changes. It is possible that increased awareness may have contributed to the decrease in mortality from cancer that has been noted in some countries. Women should, therefore, be encouraged to seek medical advice if they detect any change in their s that may be cancer." - золотые слова! Именно возросшая информированность о состоянии поспособствовала уменьшению смертности. И нравится мне последняя фраза, что за медицинским советом надо обращаться, заметив подозрительные на рак изменения в ... А то скрининг-скрининг |
cancer mortality. "