Resisting the screening imperative: patienthood, populations and politics in prostate cancer detection technologies for the UK
Resisting the screening imperative: patienthood, populations and politics in prostate cancer detection technologies for the UK
复制标题
抵制筛查的必要性：英国前列腺癌检测技术中的耐心、人口和政治
DOI：
10.1111/j.1467-9566.2011.01385.x
复制
发表时间：
2011
影响因子：
2.9
通讯作者：
Faulkner A
中科院分区：
文献类型：
--
作者：
Faulkner A
在英国引入大规模筛查计划一直备受争议。它是有益的检查医疗条件，筛查已被积极考虑，但没有引进，如前列腺癌。在过去的20年中，该疾病的发病率不断上升，部分原因是PSA（前列腺特异性抗原）检测技术的使用激增。这场争论正在进入一个新的阶段，与新的分子遗传生物标志物的开发和来自基因组关联研究的测试有关。本文概述了三种类型的检测技术- PSA，遗传学和基因组学的最新科学和技术发展。应用风险、技术治理和技术期望的概念，结果表明，中央公共卫生治理行为体继续通过各种日益多样化的治理模式抵制新技术的浪潮。在PSA的情况下，治理趋势超越了“责任化”，以公民的权利，而在基因检测和基因组风险分析的情况下，国家公共卫生机构被证明是从事技术期望管理的形式，因为它响应了私人商业测试和中介化的未来医疗保健的科学为基础的愿景的新市场。
The introduction of mass screening programmes in the UK has been controversial. It is instructive to examine medical conditions for which screening has been actively considered but not introduced, such as prostate cancer. Incidence of the disease has escalated during the last 20 years, partly due to the upsurge in use of PSA (prostate‐specific antigen) detection technology. The controversy is moving into a new phase, associated with the development of new molecular genetic biomarkers and tests derived from genome‐association studies. The paper outlines the most recent scientific and technological developments for the three types of detection technology – PSA, genetic, and genomic. Applying concepts of risk, technology governance and technology expectations, it is shown that central public health governance actors continue to resist the tidal wave of new technologies through a variety of increasingly diverse governance modes. In the case of PSA, a governance trend moving beyond ‘responsibilisation’ to citizen rights is shown, whereas in the case of genetic tests and genomic risk profiling, state public health agencies are shown to be engaging in a form of technology expectation management, as it responds to a new marketplace of private commercial testing and mediatised science‐based visions of future healthcare.