肿瘤预防与筛查原则的哲学思考

Philosophical Thinking on the Principles of Cancer Prevention and Screening

随着对肿瘤机制的深入研究,发现传统肿瘤筛查虽能减缓疾病进展,但对肿瘤预防来说效能较低,还存在过度诊断等问题。尤其是近几年基于多组学大数据挖掘及科学验证提出的精准医学,为肿瘤的防治提供了新策略,因此精准早期筛查越来越迫切。根据肿瘤发病机制及发病风险因素对人群细分,减少预防策略相关危害,是制定精准筛查策略的核心要素。并提出要量化风险确定筛查人群,建立高风险群体分层机制,依据疾病异质性制定干预方案,选择检测的最佳时机,以及保证筛查策略在群体中实施的公平性的筛查原则。

With the in-depth study of tumor mechanism,traditional tumor screening is acknowledged to slow down the progress of disease,but it has low efficiency for tumor prevention,over diagnosis behind it is not rare.Especially in recent years,precision medicine based on multi-omics big data screening and scientific verification provides a new strategy for cancer prevention and treatment.Accurate screening in early stages is urgently called.The core element in accurate screening strategy is to categorize population with details according to tumor pathogenesis and risk,which will lower risks in preventive strategies.It is suggested to quantify the risk locating screening population,establish a hierarchical mechanism for high-risk groups,formulate intervention programs according to disease heterogeneity,select the best timing for tests,and ensure the fairness of screening strategies in the population.