对癌症早发现、早诊断、早治疗方针的考量

Reflections on the Guidance of Early Detection,Early Diagnosis and Early Treatment of Cancer

有些癌症进展很慢,也不扩散,可谓"惰性癌"。通过分析同一地区不同时期人群癌症发病率、5年生存率和死亡率变化之间的关系;开展前瞻性队列研究,比较癌症筛检人群和非筛检人群癌症发病率和死亡率的差别;检查非癌症死亡者体内有无癌症病理病灶等途径,显示惰性癌普遍存在的线索,提出实施早发现早诊断早治疗方针,可能会在诊断和治疗的癌症病人中包含很多惰性癌,从而推高发病率和治愈率,却较少降低死亡率。建议不要在健康人群开展癌症筛检,并大力加强对惰性癌的研究。

Some eaneers progress very slowly and are not metastatic, which can be termed as indolent cancers. This paper summarizes the clues supporting the widespread exislence of indolent cancers from following aspects： the changes of cancer incidence, five year survival rale and mortality in different decades in the same region： the differences in cancer incidence and mortality between the screened crowd and those unscreened in prospective studies： and the existence of cancer lesions in the aulopsy of non cancer dead. Therefore, in the implementation of guidelines of early detection,early diagnosis and early treatment, cancer screening in healthy people may diagnose and trent many indolent cancer patients, which merely increases the incidence and recovery rate, bul has carry on cancer screening in heallhy people, but to strengthen the research on indolent cancers.