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JAMA:美国预防部门发文,无症状,不建议筛查甲状腺癌

2017-05-11 文韬 中国循环杂志

近日,美国预防服务工作组发文,不推荐对没有症状的成人筛查进行甲状腺癌。

近日,美国预防服务工作组发文,不推荐对没有症状的成人筛查进行甲状腺癌。

过去10年来,甲状腺癌的发病率每年增加4.5%,远超其他肿瘤,但是死亡率并没有相应的变化。大多数甲状腺癌患者预后良好,甲状腺癌整体5年生存率为98.1%。

USPSTF认为,甲状腺癌相对比较少见,一些观察性研究发现,在大规模筛查计划后,死亡率无明显变化。因此筛查和治疗的整体益处不大。

USPSTF认为,筛查可能导致过度诊断和治疗。

但对于喉咙相关症状,如嘶哑、疼痛和吞咽困难;以及颈部相关表现,例如肿块、肿胀和不对称等怀疑甲状腺疾病的患者应警惕。

但也有专家表示,USPSTF对“无症状”的定义过于笼统。甲状腺疾病的相关症状通常无特异性,可表现为疲倦、活力下降、思维迟钝和冷漠等,很难界定患者是否出现症状。

他说,临床上经常可以见到一些出现明显甲状腺功能减退的老年人,但医生常误以为他们的身体机能下降是年龄所致的。

原始出处:

US Preventive Services Task Force . Screening for Thyroid CancerUS Preventive Services Task Force Recommendation Statement. JAMA, 2017, 317:1882-7.

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    2017-08-16 周虎
  2. [GetPortalCommentsPageByObjectIdResponse(id=2081059, encodeId=5bb92081059f2, content=<a href='/topic/show?id=846b20389cd' target=_blank style='color:#2F92EE;'>#不建议#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20389, encryptionId=846b20389cd, topicName=不建议)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c9d3459, createdName=周虎, createdTime=Wed Aug 16 08:30:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1484962, encodeId=bd84148496282, content=<a href='/topic/show?id=4bbe5902ed2' target=_blank style='color:#2F92EE;'>#无症状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59027, encryptionId=4bbe5902ed2, topicName=无症状)], attachment=null, authenticateStatus=null, createdAvatar=Bioon/avatar/20180429/70baad2aa5a046c5aa2914d262de7d37.jpg, createdBy=bd077990475, createdName=12498da4m34(暂无昵称), createdTime=Sat May 13 02:30:00 CST 2017, time=2017-05-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196972, encodeId=f9501969e276, content=新观点要学学, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib260FNcic8ThYQJjaU2fLIb1yNqibkbdJs7gVIDr9xJyYeiapArSMjn3W61bPJtpIazSdAxRaFEOKYgfQjX4achN2d/0, createdBy=68472058812, createdName=日月生辉, createdTime=Fri May 12 08:34:50 CST 2017, time=2017-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196725, encodeId=a7fe196e2592, content=筛查不会有获益,甲状腺癌进展太慢了, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Thu May 11 19:49:41 CST 2017, time=2017-05-11, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=2081059, encodeId=5bb92081059f2, content=<a href='/topic/show?id=846b20389cd' target=_blank style='color:#2F92EE;'>#不建议#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20389, encryptionId=846b20389cd, topicName=不建议)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c9d3459, createdName=周虎, createdTime=Wed Aug 16 08:30:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1484962, encodeId=bd84148496282, content=<a href='/topic/show?id=4bbe5902ed2' target=_blank style='color:#2F92EE;'>#无症状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59027, encryptionId=4bbe5902ed2, topicName=无症状)], attachment=null, authenticateStatus=null, createdAvatar=Bioon/avatar/20180429/70baad2aa5a046c5aa2914d262de7d37.jpg, createdBy=bd077990475, createdName=12498da4m34(暂无昵称), createdTime=Sat May 13 02:30:00 CST 2017, time=2017-05-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196972, encodeId=f9501969e276, content=新观点要学学, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib260FNcic8ThYQJjaU2fLIb1yNqibkbdJs7gVIDr9xJyYeiapArSMjn3W61bPJtpIazSdAxRaFEOKYgfQjX4achN2d/0, createdBy=68472058812, createdName=日月生辉, createdTime=Fri May 12 08:34:50 CST 2017, time=2017-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196725, encodeId=a7fe196e2592, content=筛查不会有获益,甲状腺癌进展太慢了, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Thu May 11 19:49:41 CST 2017, time=2017-05-11, status=1, ipAttribution=)]
    2017-05-12 日月生辉

    新观点要学学

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2081059, encodeId=5bb92081059f2, content=<a href='/topic/show?id=846b20389cd' target=_blank style='color:#2F92EE;'>#不建议#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20389, encryptionId=846b20389cd, topicName=不建议)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c9d3459, createdName=周虎, createdTime=Wed Aug 16 08:30:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1484962, encodeId=bd84148496282, content=<a href='/topic/show?id=4bbe5902ed2' target=_blank style='color:#2F92EE;'>#无症状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59027, encryptionId=4bbe5902ed2, topicName=无症状)], attachment=null, authenticateStatus=null, createdAvatar=Bioon/avatar/20180429/70baad2aa5a046c5aa2914d262de7d37.jpg, createdBy=bd077990475, createdName=12498da4m34(暂无昵称), createdTime=Sat May 13 02:30:00 CST 2017, time=2017-05-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196972, encodeId=f9501969e276, content=新观点要学学, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib260FNcic8ThYQJjaU2fLIb1yNqibkbdJs7gVIDr9xJyYeiapArSMjn3W61bPJtpIazSdAxRaFEOKYgfQjX4achN2d/0, createdBy=68472058812, createdName=日月生辉, createdTime=Fri May 12 08:34:50 CST 2017, time=2017-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196725, encodeId=a7fe196e2592, content=筛查不会有获益,甲状腺癌进展太慢了, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Thu May 11 19:49:41 CST 2017, time=2017-05-11, status=1, ipAttribution=)]
    2017-05-11 lovetcm

    筛查不会有获益,甲状腺癌进展太慢了

    0

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