Screening strategy on precision prevention strategies for three types of malignant tumors
10.19428/j.cnki.sjpm.2022.21705
- VernacularTitle:筛查在三类恶性肿瘤精准预防策略中的意义
- Author:
Shiliang CAI
1
;
Rui PU
1
;
Donghong LIU
2
;
Zishuai LI
1
;
Xinyu ZHOU
1
;
Hongsen CHEN
1
;
Yida HE
1
;
Guangwen CAO
1
Author Information
1. Department of Epidemiology, Naval Medical University, Shanghai 200433, China
2. Department of Hepatic Surgery, Third Affiliated Hospital, Naval Medical University, Shanghai 200438, China
- Publication Type:Review
- Keywords:
cancer;
screening;
precision prevention;
early diagnosis;
overtreatment
- From:
Shanghai Journal of Preventive Medicine
2022;34(7):705-711
- CountryChina
- Language:Chinese
-
Abstract:
Malignant tumors can be classified into three categories， rapidly progressing tumors， slowly progressing tumors， and "indolent" tumors. Rapidly progressing tumors （such as liver cancer， pancreatic cancer， and cholangiocarcinoma） have acute onset， shorter time duration from onset to death， and poorer treatment effects， which warrants primary prevention. Slowly progressing tumors （such as lung cancer， colorectal cancer， breast cancer， and gastric cancer） have slow onset， clear precancerous lesions， longer time duration from onset to death， and better therapeutic effects， which is accordingly suitable for secondary prevention. “Indolent” tumors （such as prostate and thyroid cancer） do not affect the life expectancy and are suitable for tertiary prevention. Early screening of “indolent” tumors may lead to overtreatment. Furthermore， early screening of rapidly progressing tumors is difficult to identify early cancers， which results in low cost-effectiveness. In contrast， for slowly progressing tumors suitable for secondary prevention， early screening may have cost-effectiveness， though there might be over-diagnosis. It is crucial to adopt appropriate prevention and treatment strategies for diverse types of tumors. Currently， large-scale cohort studies and randomized controlled clinical trials with complete follow-up may accurately evaluate the effect of cancer prevention strategies. This review discusses the significance of screening in precision prevention of tumors based on the characteristics of tumor progression and patients’ prognosis.
