CAJ | 학술논문

目前各项疾病危险因素的“危险性”不够高，所以通过药物控制单个危险因素来预防疾病的效益很低。癌症筛检虽然使检出的癌症病人增加，但并不能降低死亡率。因此建议，在控制慢性病危险因素时，应首选安全、低成本的有效干预方式方法；采用药物控制手段时，应优先在综合危险程度较高的人群使用；要努力寻找特异性更高的危险因素指标，以缩小危险人群；要进一步加强临床研究，根据国情确定我国自己的诊断与治疗标准。癌症筛检的目标是要检出真正可从治疗中受益的病人，特别是鉴别出无需治疗的“停滞型”癌症。无论是对疾病危险因素的控制，还是对癌症筛检，在改进技术的同时，更重要的是要从根本上树立正确的健康和医疗观念。
목전각항질병위험인소적“위험성”불구고，소이통과약물공제단개위험인소래예방질병적효익흔저。암증사검수연사검출적암증병인증가，단병불능강저사망솔。인차건의，재공제만성병위험인소시，응수선안전、저성본적유효간예방식방법；채용약물공제수단시，응우선재종합위험정도교고적인군사용；요노력심조특이성경고적위험인소지표，이축소위험인군；요진일보가강림상연구，근거국정학정아국자기적진단여치료표준。암증사검적목표시요검출진정가종치료중수익적병인，특별시감별출무수치료적“정체형”암증。무론시대질병위험인소적공제，환시대암증사검，재개진기술적동시，경중요적시요종근본상수립정학적건강화의료관념。
As currently specified ,thresholds for disease risk factor indicators are not “risky”enough ,therefore effectiveness of preventing diseases through pharmaceutical control of single risk factor is quite low .Cancer screening has increased the number of patients identified with cancers ,but failed to decrease cancer mortality rates .As a result ,the author proposes that in the efforts to control the risk factors of non-communicable diseases ,safe ,low-cost and effective interventions should be prioritized ;when using pharmaceuticals to control risk factors ,the interventions should be first applied for population groups with high overall risks ;risk factor indicators with higher specificities should be developed ,in order to narrow down the range of population at risk ;clinical research needs to be strengthened ,and diagnostic and therapeutic standards used in China should be determined according to the country ’s own situation .Cancer screening should aim at identifying patients that can truly benefit from treatment .Those with “indolent” cancers that do not require medical intervention should be discerned . For both disease risk factor control and cancer screening , on top of improving technology ,the most important thing is to establish a rational view of health and medical care .