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害怕乳腺癌?经常检查其实没什么用 – 译学馆
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害怕乳腺癌?经常检查其实没什么用

The Little Known Truth About Mammograms

学院幽默
College Humor
《ADAM毁了一切》
ADAM RUINS EVERYTHING
你好
-Hi!-Hi!
我是Elmore医生我是Rachel
-I’m Dr.Elmore.-I’m Rachel.
见到你很高兴 我今天能为你做点什么?
Nice to meet you. How can I help you today?
我不想推进
I don’t want to think pushing,
我想做一个乳房扫描检查
but I need a mammogram now.
你能说说为什么嘛?
Can you tell me a little bit more about why?
我没有发现任何肿块
I haven’t found a lump or anything.
我只想拍张片
I just need to get screened,
好知道 我有没有癌症
so I know I don’t have cancer.
请坐
Okay, let me sit down,
我们说说
let’s talk about this.
癌症筛查是一个复杂的话题
Cancer screening is a complicated topic.
我进来之前看了你的病历
I looked at your medical record before I came in
你35了
and it says that you’re 35 years old
你也没有乳腺癌家族病史
you don’t have any family history of breast cancer
没有风险因素 对吧
no risk factor, correct?
我今天不想给你推荐乳腺透视
Then I would not recommend a screening mammogram today.
为什么不呢?
Why on earth not?
乳腺癌我们都怕它
Breast cancer is something that many of us fear.
我们也有许多关爱的人罹患了乳腺癌
Many of us have loved ones who’ve suffered from it.
乳房X射线筛查的真相是
But the truth about screening mammograms is that
好处没有我们想象的多
the benefit is less than we had hoped
而它的害处比我们想象的大
and they are real harms more than people think.
就如人们网上的评论
It sounds like that human internet comment.
你需要去见见ADAM
Oh, you must need Adam.
我们在书吧和Adam聊这个话题
We were just talking with Adam about this at book club.
Elmore医生 是你吗?家里有人吗?
Dr Elmore, is it you? How’s the family?
好的 ADAM 进来吧
Fine, Adam, you can come in.
我不是在看 非常尊重
I’m not looking. Very respectful.
Rachel 这位是Joann Elmore
Rachel, this is Joann Elmore.
她是华盛顿大学的医学教授
She is a doctor professor university Washington
也是一名乳腺癌检测方面的专家
and an expert on breast cancer screenings.
ADAM 我就说这些
Adam, I’m over here.

Woo!
我不理解
I don’t understand.
妇女们需要不时来检查
I thought every woman needed screenings like constantly.
是的 医生和拥护者们数十年来就一直这么认为的
Yeah, that’s what doctors and advocacy groups have told us for decades.
上世纪80年代 美国癌症协会甚至还打过一个广告
In the 80s, the American Cancer Society even ran an ad that said
如果你没有做乳腺射线检测
if you haven’t had a mammogram
一定要多去检测
you need more than your breast examined.
无耻
Wow! That’s insulting.
80年代 这都是意料之中的事
Par for the course for the 80s.
但在前几年 新的研究
But in the last few years, new research has caused
说法有些改变
some of the recommendations to change.
美国癌症团体 美国预防与服务特别小组
The American Cancer Society, the US Preventive Services Task Force
美国内科学会都建议
and the American College of Physicians have all recommended
降低对乳腺扫描的频次 开始筛查的年龄不断推后
getting mammogram screenings less frequently and begining them later in life.

Ah!
真的吗?为嘛?
Really? Why?
乳腺扫描可以挽救生命
Most screening mammogram can and do save lives.
它对挽救生命
The actual number of life saved
没人想象的那么厉害
is much smaller than most people think.
基于诊所的随机抽样
Based on randomized clinical trails,
抽取一万名40多岁的女性
if you took 10,000 women in their forties,
假如她们很长时间没有进行乳腺检测
here is how many might died of breast cancer
会有多少人死于乳腺癌
if they didn’t get any mammograms for a dacade.
如果她们接受乳腺扫描 有多少人
And here is how many of those same women might die
会罹患乳腺癌死去
if they did get those mammogram screenings.
摘了你的眼罩
Take off your blindfold.
她们看上去一样多
They both look the same.
的确 妇女中做了乳腺扫描的和控制组 两组数据
Exactly, there was no statisticly significant difference between
无显著差异
the women who got the mammograms and the control group.
怎么会这样呢?
How can that be?
通过扫描找出了癌症
Mammograms find cancer.
很多小册子都这么说
I have many pamphlets that say that.
他们肯定找出了癌症
Well they definitely find cancer
但不是所有的癌症都是一样的
but not all cancer is the same.
你了解癌症的发病机理吗?
How do you think cancer works?
它始于一个变异细胞
Well, it starts with one bad cell
它开始分裂并扩散
it multiplies and spreads and
如果早发现 你就能活下来
if you catch it early enough then you survive
如果你不那样 那你的朋友和家人
and if you don’t, then your friends and family
每年要花5000块
run a 5K every year.
很多人都这么想
That’s what a lot of people think
但事实要复杂一点
but the truth is a lot more complicated.
有些癌症长起来很快 扫描都跟不上它的生长
Some cancer grows so fast that mammogram can’t catch it in time.
这是件可怕的事
This is an awesome thing to win!
但有些癌症开始生长 在要命之前又停下来
But some cancers start growing but then stop before they kill you.
另一些生长非常缓慢
Another cancers grow so slowly
不会要命的
they would never have the chance to kill you.
它们就是那种
Finally there’s the kind of cancer you were thinking of
你希望早点检出的
the kind you hope to catch early.
但还没有到达警戒线
Yeah, that one hasn’t reached the finish line yet.
扫描可让它及时停下来
A mammogram could stop it in time.
或许可以
it might.
问题是扫描不能区分这两种癌症的不同
The problem is mammograms can’t tell the difference between these types of cancer.
我无法把你们区分开来
Ah… I can’t tell you apart.
你们看起来都好像是致死的
You all look deadly to me.
我要一视同仁
I’m gonna treat you all the same.
当你对癌症那样做时 就太厉害了
You are so sexy when you did that to cancer.
比我想的还要没用
That is less helpful than I thought.
如果有一线希望 会救了我的命
But if there’s even a tiny chance, it’ll save my life.
对一个无伤害检测 那还行
It does seem worth it for a harmless test.
不幸的是 扫描并不是无伤害的
Unfortunately, mammograms aren’t harmless.
有时候可能女性并没有患癌
There’s a chance the x-ray will show something suspicious
但x光扫描却显示有可疑问题
when the woman doesn’t even have cancer.
结果就叫假阳性
That’s called a false positive.
这种几率对女性来讲有10%
This happens to about one out of ten women
让人非常焦虑
and it can be very stressful.
你越加频繁地去扫描
And the more often you get mammograms
你越可能得个假阳性判断
the more likely you are to get a false positive.
美国有一半多的女性每年去扫描检测
Over a half of women in the US who receive annual mammograms
数十次的得到这个结果 假阳性
will experience a false positive within a decade.
当然 有时也发现了癌症
But… okay, sometimes they do find cancer, right?
只是一小部分女性这样
In a small percentage of women yes
记着 扫描只能检出其中的一种
But remember the screening could just find one of those
良性肿瘤并不致命
harmless cancers that would never kill you.
这就是过度诊断
That’s what we call over diagnosis.
估计有两成的患者被过度诊断
Estimates are that about one in five cancers might be over diagnosed.
比例确实有点高
That’s really high!
再想想患者承受的情感和心里的折磨
Consider the emotional and psychological stress
想着自己得了不治之症
of thinking you have a deadly disease when you don’t
要不要告诉亲人
or having to tell your loved ones
太痛苦了
those are real harms.
过度诊断导致过度医疗
And overdiagnosis can lead to over treatment.
因为扫描不能区分不同类型的癌症
Since mammograms can’t tell the difference between these types of cancers,
医生对癌症严阵以待
we recommend serious treatments for all of them and
以至于有些女性接受没必要的治疗
that can result in women getting treatments they don’t need.
如化疗 放疗甚至乳房切除
Some like chemotherapy, radiation therapy and mastectomy
对身体产生负面影响
take a serious toll on the body.
就好像你告诉我 我可能患有懒癌
So you’re telling me I could have that lazy cancer
那是不会伤害我的癌症
that would never have hurt me
仍被告知去做化疗
but still be told to get chemo.
完全有可能
Yeah, it’s entirely possible.
妈哈
Holy crow!
给出个假阳性的结果出来
Taken together, given the false positives over diagnosis,
用过度治疗代替扫描检查
over treatment instead of rushing in to get screening.
希望女性能重视这些数据
I want women to weigh all of the data
慎重抉择
and make an informed choice.
前列腺和甲状腺扫描检查 也有同样的问题
Prostate and thyroid cancer screenings have the same issue by the way.
我过去常去前列腺检查
You know, I used to get my prostate checked
在看到这个之前 每两周检一次
twice a week before I found this out.
我怎么做呢?
So, what should I do?
如果你发现了肿块异常
If you do feel a lump or unnormality,
请去看大夫
please go to your doctor.
如果他们建议做一个扫描 那就做一个
And if they recommend a mammogram, get one at that time.
如美国预防与服务组织曾说过
Apart from that the US Preventive Services Task Force recommends talking to
40多岁时 你要问医生是否要开始扫描检查
your doctor in your forties about whether you want to start screenings
否则 他们建议你去做
then and otherwise they suggest getting them
50岁起每两年检一次
every two years starting in your fifties.
那样利大于弊
That’s when the benefit is more and the harms are less.
我想 今天就不做了
I guess I… I won’t get one today then…
关于乳腺癌的治疗
There is some good news our treatment of breast cancer
有一些消息比过去好多了
is so much better than it used to be.
死亡率明显下降
The mortality has dropped significantly and
我们能治愈大多数的乳腺癌
we’re able to cure most women with breast cancer regardless of
不管它是否由扫描检出
whether the cancer was detected on a screening exam or not.
谢谢你 医生
Thanks, Dr. Elmore.
你好 我是ADAM 如果你喜欢这些
Hey, Adam being here. If you like that,
请观影最新一集的《ADAM RUINS EVRYTHING》
be sure to watch all new episodes of ADAM RUINS EVERYTHING
每周二10点在truTV
every Tuesday at 10:00 on truTV.

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视频概述

不要轻易去做乳腺扫描检查

听录译者

一线通途

翻译译者

Tiger_woo

审核员

审核员YX

视频来源

https://www.youtube.com/watch?v=Ni9TQHOsHUQ

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