Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement
Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement
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DOI：
10.7326/0003-4819-151-10-200911170-00008
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发表时间：
2009-11-17
影响因子：
39.2
通讯作者：
Wilt, Timothy
中科院分区：
文献类型：
--
作者：
Calonge, Ned;Petitti, Diana B.;Wilt, Timothy
描述：2002年美国的更新。S.预防服务工作组（USPSTF）的建议声明筛查乳腺癌在一般population.Methods：USPSTF检查的证据的有效性5筛查模式在降低乳腺癌的死亡率：电影乳房X线摄影，临床乳腺检查，乳房自我检查，数字化乳房X线摄影，磁共振成像，以更新2002年的建议。为了完成这一更新，USPSTF委托进行了2项研究：1）对6个选定的与筛查的益处和危害相关的问题进行了有针对性的系统证据审查; 2）使用人群建模技术进行决策分析，以比较在不同年龄开始和结束乳腺X线摄影筛查以及使用年度与两年期筛查间隔的预期健康结局和资源需求。USPSTF建议40至49岁的女性不要进行常规的乳房X光检查。在50岁之前开始定期、每两年筛查一次的乳腺X射线摄影的决定应该是个人的决定，并考虑到患者的背景，包括患者对特定益处和危害的价值观。（C级建议）USPSTF建议50至74岁的女性每两年进行一次筛查性乳房X光检查。（B级建议）USPSTF得出结论，目前的证据不足以评估75岁或以上女性筛查乳房X光检查的额外益处和危害。USPSTF的结论是，目前的证据不足以评估40岁或以上女性在筛查性乳房X光检查之外进行临床乳房检查的额外益处和危害。USPSTF建议临床医生不要教女性如何进行乳房自我检查。（D级建议）USPSTF得出结论，目前的证据不足以评估数字乳腺X射线摄影或磁共振成像替代胶片乳腺X射线摄影作为乳腺癌筛查方式的额外益处和危害。（一声明）
Description: Update of the 2002 U. S. Preventive Services Task Force (USPSTF) recommendation statement on screening for breast cancer in the general population.Methods: The USPSTF examined the evidence on the efficacy of 5 screening modalities in reducing mortality from breast cancer: film mammography, clinical breast examination, breast self-examination, digital mammography, and magnetic resonance imaging in order to update the 2002 recommendation. To accomplish this update, the USPSTF commissioned 2 studies: 1) a targeted systematic evidence review of 6 selected questions relating to benefits and harms of screening, and 2) a decision analysis that used population modeling techniques to compare the expected health outcomes and resource requirements of starting and ending mammography screening at different ages and using annual versus biennial screening intervals.Recommendations: The USPSTF recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take into account patient context, including the patient's values regarding specific benefits and harms. (Grade C recommendation)The USPSTF recommends biennial screening mammography for women between the ages of 50 and 74 years. (Grade B recommendation)The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older. (I statement)The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination beyond screening mammography in women 40 years or older. (I statement)The USPSTF recommends against clinicians teaching women how to perform breast self-examination. (Grade D recommendation)The USPSTF concludes that the current evidence is insufficient to assess additional benefits and harms of either digital mammography or magnetic resonance imaging instead of film mammography as screening modalities for breast cancer. (I statement)