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研究再次就乳房摄影术的价值提出争议(上)
http://www.100md.com 2001年10月23日 好医生
     NEW YORK, Oct 19 (Reuters Health) - Danish researchers say a re-analysis of their controversial study of a year ago confirms their original conclusions--that there is no evidence that breast-cancer screening with mammography saves women's lives.

    When the original report was published last year in The Lancet, it garnered widespread criticism from breast cancer experts who questioned the researchers' reasoning and conclusions. So Drs. Peter C. Gotzsche and Ole Olsen of the Nordic Cochrane Centre in Copenhagen re-analyzed their data according to the protocol of the Cochrane Collaboration, an international organization that has established rigorous standards for conducting and publishing research reviews.

    But their conclusion about mammography remains the same, according to a report in the October 20th issue of The Lancet.

    According to Gotzsche and Olsen, flawed methods have troubled studies that have indicated mammography saves women's lives by catching breast cancer early. Out of eight studies they reviewed, they deem only two to be of good quality. And those two trials suggested that mammograms have made no dent in breast cancer deaths.

    In their original study, the researchers cited problems with the way many mammography trials have been conducted--including imbalances in terms of the women's ages and other factors that they charge skewed the study results in favor of mammography. But others pointed to shortcomings in Gotzsche's and Olsen's work, and the current report represents an effort to answer those criticisms.

    But a US expert told Reuters Health this re-analysis does not refute the criticisms that have been lobbed at the Danish researchers. More importantly, it does not change the public health recommendation that women get a mammogram every year or two starting at age 40.

    "The overwhelming weight of the evidence shows that mammography saves lives," Dr. Robert Smith of the American Cancer Society (ACS) said in an interview.

    In fact, Smith pointed out, an ACS report released earlier this year concluded that mammography has saved twice as many lives as experts have suspected. Three decades' worth of data from Sweden suggested that the introduction of routine mammography in 1987 had led to a 63% reduction in breast cancer deaths among women ages 40 to 69., 百拇医药