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(单词翻译:双击或拖选)
U.S. and European researchers say the leading test used to screen for prostate cancer may do more harm than good. The new studies are re-igniting debate over the aggressive treatments associated with prostate cancer.
For 20 years doctors have used the prostate-specific antigen test, better known as PSA, to screen for cancer in the walnut-sized prostate gland2 in the male reproductive system. But controversy3 has surrounded the test and some doctors say it has led to overdiagnosis and overtreatment of prostate cancer, one of the most common types of cancer in men in the Western world.
In two interim4 studies to be published next week in the prominent New England Journal of Medicine, U.S. and European researchers found little to no benefit in PSA screening.
In a discussion on the journal's Web site, Dr. Philip Kantoff of Harvard Medical School, says there can be a downside to early treatment in a slow developing disease.
"When you use PSA, you diagnose prostate cancer, and the benefits of diagnosing that prostate cancer, generally, in its early form, are not seen for probably 10 to 15 years," he explained. "Yet the downside effects of PSA screening are immediate5 if a patient undergoes treatment."
According to Dr. Mary McNaughton-Collins, a researcher at Massachusetts General Hospital and Harvard Medical School, aggressive treatments can lead to side effects such as impotence, incontinence and even early death. She says the problem lies in not having the scientific advances to differentiate6 between tumors that do not need to be treated from the aggressive cancer that does.
"I think the onus7 is on us, to maintain that healthy skepticism about a screening program that's built on inconclusive data on whether or not we are helping8 more men than we're hurting," she said.
Kantoff agrees, saying much of the controversy would diminish if more doctors would separate detection from treatment. Prostate cancer is slow growing and if properly monitored, Kantoff says, for many patients it can be left alone.
Dr. McNaughton-Collins says physicians need to acknowledge the controversy and fully9 inform their patients of the tradeoffs.
"For men in my own practice, for some men the PSA decision is the right one," she said. "For many of my men, once they're fully informed, they decide to forgo10 the PSA test. And for those men, that is the right decision."
McNaughton-Collins points out that the U.S Preventive Services Task Force, which makes recommendations about health care screenings, concluded that the evidence is insufficient11 to determine whether there are more pros1 than cons12 to prostate cancer screening in men younger than 75. They have, however, discouraged screening for men 75 years or older.
She says physicians need to consider their patient's preferences and make it a shared decision-making process on whether to forgo the test.
1 pros | |
abbr.prosecuting 起诉;prosecutor 起诉人;professionals 自由职业者;proscenium (舞台)前部n.赞成的意见( pro的名词复数 );赞成的理由;抵偿物;交换物 | |
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2 gland | |
n.腺体,(机)密封压盖,填料盖 | |
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3 controversy | |
n.争论,辩论,争吵 | |
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4 interim | |
adj.暂时的,临时的;n.间歇,过渡期间 | |
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5 immediate | |
adj.立即的;直接的,最接近的;紧靠的 | |
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6 differentiate | |
vi.(between)区分;vt.区别;使不同 | |
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7 onus | |
n.负担;责任 | |
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8 helping | |
n.食物的一份&adj.帮助人的,辅助的 | |
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9 fully | |
adv.完全地,全部地,彻底地;充分地 | |
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10 forgo | |
v.放弃,抛弃 | |
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11 insufficient | |
adj.(for,of)不足的,不够的 | |
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12 cons | |
n.欺骗,骗局( con的名词复数 )v.诈骗,哄骗( con的第三人称单数 ) | |
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