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如何诊断这种最致命的癌症 – 译学馆
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如何诊断这种最致命的癌症

How to detect the deadliest form of cancer | The Economist

相比于其他类型的肿瘤 肺癌致命性更强
Lung cancer kills more people than any other form of tumour
大约九成患者都会
About nine out of ten people die
在被诊断出患有肺癌的五年内死亡
within five years of being diagnosed with the disease
如果癌症发现较早
If the cancer is caught very early
多数病人能够被治愈
most patients could be cured
但医生很难在早期做出诊断
But doctors struggle to diagnose early
因为癌症只有到了晚期
because there are no symptoms
并且癌细胞扩散到了其他器官
until the cancer is in its late stages
否则是没有任何征兆的
and has spread to other organs
一些专家认为医生应该
Some experts think that doctors should
在症状出现之前
screen people at high risk to find lung cancer
就去筛查高危人群以发现肺癌
before symptoms appear
美国全国肺癌筛查实验
The national lung-screening trial in America
让53000名目前和曾经的重度吸烟者
subjected 53,000 current and former heavy smokers
每年接受X光或者计算机断层扫描(CT)
to either X-ray or computed-tomography scans
并持续了三年
every year for three years
根据2011年发布的结果显示
its results reported in 2011 found during the screening
通过CT扫描来筛查确实能挽救生命
found that screening with CT scans did save lives
但有个问题
But there was a problem
在筛查中发现的大量肿块
Too many of the lumps found during the screening
都不是癌症
were not cancer
这被称为假阳性
This is known as a false positive
假阳性可能会给那些
False positives can harm patients
需经受活检等后续危险检查的病人带来伤害
who undergo dangerous follow-up procedures such as biopsies
即使他们并没有癌症
even if they do not have cancer
这还会影响他们的心理健康
It can also affect their mental health
假阳性还增加了医疗负担
and false positives add to the cost of health care
根据世界健康组织的新数据显示
According to new data from the World Health Organisation…
通过适当改变筛查方案
these harms can be greatly reduced
这些危害就能够大幅度减少
…by following a different protocol
(新方案)建议医生忽略那些最小的瘤
Instead of treating all lumps as a positive result
并将它们当作阴性来处理
doctors are now advised to ignore the smallest nodules
而不是将所有肿块都视为阳性
and treat them as a negative result
这样假阳性几率会减半
This has halved the rate of false positives
在1000名接受扫描的人中
Out of every 1,000 people who were scanned…
根据旧方案 356人需要进行后续检查
356 people required follow-up testing under the old protocol
而新方案中
With the new protocol,
后续检查人数下降到了180人
that has fallen to 180
后续检查所引起的并发症也相应减少了
Complications from follow-up testing have also been reduced
这些结果非常乐观
These results show promise
为了决定是否设立完善的筛查项目
Many countries are waiting for the full report of another trial called Nelson…
许多国家都在等另一个叫纳尔逊实验的详细报告
…before deciding whether to set up fully fledged screening programmes
来自纳尔逊实验的原始数据显示
Preliminary data from the Nelson trial
筛查减少了26%的高危男性
suggest that screening reduces the death rate from lung cancer among high-risk men by 26%
以及61%的女性的肺癌死亡率
and 61% in women
如果能找到筛查的成本和利益的平衡
If a balance between the cost and benefits of screening can be found
肺癌将不再是
lung cancer need no longer be
一个死亡宣判
a death sentence

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肺癌的早期筛查有助于降低死亡率

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