新研究对乳腺癌X光筛查提出进一步质疑

2014-10-08 16:59:59来源：可可英语

　　"It will make women uncomfortable, and they should be uncomfortable," said Dr. Russell P.Harris, a screening expert and professor of medicine at the University of North Carolina. "Thedecision to have a mammogram should not be a slam dunk."

　　“这会让女性感到不舒服，她们也理应感到不舒服，”筛查专家、北卡罗莱纳大学(University of NorthCarolina)医学教授拉塞尔·P·哈里斯(Russell P. Harris)说。“决定做乳房X光检查本来也不应该是一桩乐事。”

　　The findings will not lead to any immediate change in guidelines for mammography, and manyadvocates and experts will almost certainly dispute the idea that mammograms are on balanceuseless, or even harmful.

　　这些研究结果不会立刻导致乳房X光检查准则的更改，很多倡导者和专家几乎肯定会对“乳房X线检查总体无用，甚至有害”的观点进行质疑。

　　Dr. Richard C. Wender, chief of cancer control for the American Cancer Society, said thesociety has convened an expert panel that is reviewing all studies on mammography, includingthe Canadian one, and would issue revised guidelines later this year. He added that combineddata from clinical trials of mammography showed it reduces the death rate from breast cancerby at least 15 percent for women in their 40s and by at least 20 percent for older women.

　　理查德·C·文德(Richard C. Wender)博士是美国癌症协会(American Cancer Society)癌症控制主任，他说该协会已经召集了一个专家小组，正在审查和乳房X光检查有关的所有研究，加拿大的这项研究也包括在内，今年晚些时候，他们将发布修订后的准则。他还说，乳房X光检查的临床试验的综合数据显示，在40多岁的女性中，乳房X光检查至少降低了15%的乳腺癌死亡率，在年龄更大的女性中降低了至少20%。

　　That means that one woman in 1,000 who starts screening in her 40s, two who start in their50s and three who start in their 60s will avoid a breast cancer death, Dr. Harris said.

　　这意味着，在40多岁开始筛查的1000名女性中，有一名将避免死于乳腺癌，50岁开始的有两名，60岁开始的有三名，哈里斯博士说。

　　Dr. Wender added that while improved treatments clearly helped lower the breast cancer deathrate, so did mammography, by catching cancers early.

　　文德博士指出，改善后的治疗方法显然有助于降低乳腺癌死亡率，做乳房X光检查也是一样，因为可以提早发现癌症。

　　But an editorial accompanying the new study said that earlier studies that foundmammograms helped women were done before the routine use of drugs like tamoxifen thatsharply reduced the breast cancer death rate. In addition, many studies did not use the gold-standard methods of the clinical trial, randomly assigning women to be screened or not.

　　但跟这项新研究同时发表的一篇社论说，那些发现乳房X光检查有利于女性的早期研究，是在如今常规使用的药物大幅降低乳腺癌死亡率之前进行的，这些药物包括他莫昔芬(Tamoxifen);此外，很多研究没有采用标准最高的临床试验方法，随机分配女性是否接受筛查。

　　Dr. Mette Kalager, an epidemiologist and screening researcher at the University of Oslo and theHarvard School of Public Health who wrote the editorial, said there was a reason its resultswere unlike those of earlier studies. With better treatments, like tamoxifen, it was lessimportant to find cancers early. Also, she said, women in the Canadian studies were aware ofbreast cancer and its dangers, unlike women in earlier studies who were more likely to ignorelumps.

　　这篇社论的作者梅特·卡拉格(Mette Kalager)博士是奥斯陆大学(University of Oslo)和哈佛大学公共卫生学院(Harvard School of Public Health)的流行病学家和筛查研究员，她表示，这项研究的结果不同于早期的那些研究是有原因的。有了更好的治疗手段，比如他莫昔芬，提早发现癌症肿块就不那么重要了。此外她还表示，加拿大那项研究中的女性了解乳腺癌及其危险，而早期研究中的女性更有可能会忽视肿块。

　　"It might be possible that mammography screening would work if you don't have anyawareness of the disease," she said.

　　“如果你完全没有乳腺癌的意识，乳房X光检查就有可能效果不错，”她说。

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