Overview of Screening: Where We Are and Where We May Be Headed
Overview of Screening: Where We Are and Where We May Be Headed
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DOI：
10.1093/epirev/mxr006
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发表时间：
2011-07-01
影响因子：
5.5
通讯作者：
Harris, Russell
中科院分区：
文献类型：
--
作者：
Harris, Russell
本卷《流行病学评论》继续了证据界多年来关于筛查的讨论。从不同的角度来看，这些综述的作者考虑了筛查多种疾病的益处和危害;益处和危害（以及成本）之间的平衡往往不清楚。除了少数例外，筛查对改善公众健康的贡献很小，但它已成为一种流行和日益增长的预防形式。这可能是因为我们正在了解到，筛查的好处比我们希望的要少，而危害可能比我们想象的要大。也许我们不应该把筛查看作是我们的初级预防策略，而是利用筛查对少数情况下的人口健康做出真实的但有限的贡献。我们可能会将筛查目标锁定在具有最高潜在益处和最低潜在危害的较小亚群。如果我们将目前用于筛查的部分资源用于开发、测试和实施替代方法，以预防对人口健康的重要威胁，那么人口健康的回报可能会更大。需要与公众就这些问题进行更广泛的讨论。
This volume of Epidemiologic Reviews continues a discussion about screening within the evidence community that has been going on for many years. From various perspectives, the authors of these reviews consider the benefits and harms of screening for multiple conditions; the balance between benefits and harms (and costs) is often not clear. With few exceptions, the contribution of screening to improving the health of the public is small, yet it has become a popular and growing form of prevention. It may be that we are learning that the magnitude of benefit from screening is less than we hoped, and the harms may be greater than we thought. Perhaps we should not think of screening as our primary prevention strategy but rather use screening to make a real, but limited contribution to population health for a few conditions. We might target screening to smaller subpopulations with the highest potential benefit and the lowest potential harm. The payoff for population health could be greater if we shifted some resources we now devote to screening to developing, testing, and implementing alternative approaches to preventing the important threats to population health. There needs to be a wider discussion about these issues with the public.