TEYXOS 172 3/17/09 11:13 AM Page 3 - μ. πιτσιλιδης α.ε.
TEYXOS 172 3/17/09 11:13 AM Page 3 - μ. πιτσιλιδης α.ε.
TEYXOS 172 3/17/09 11:13 AM Page 3 - μ. πιτσιλιδης α.ε.
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<strong>TEYXOS</strong> <strong><strong>17</strong>2</strong> 3/<strong>17</strong>/<strong>09</strong> <strong>11</strong>:14 <strong>AM</strong> <strong>Page</strong> 79<br />
το «ποτήρι» της πρόληψης;<br />
δέκ<strong>α</strong> που θ<strong>α</strong> σωθούν!-, στο δ<strong>ε</strong>ύτ<strong>ε</strong>ρο, <strong>μ</strong><strong>ε</strong><br />
<strong>μ</strong>ί<strong>α</strong> <strong>α</strong>διάφορη έκκληση προς το σύντροφό<br />
της: «<strong>α</strong>γάπη <strong>μ</strong>ου ν<strong>α</strong> <strong>μ</strong>η ξ<strong>ε</strong>χάσου<strong>μ</strong><strong>ε</strong> ν<strong>α</strong><br />
<strong>α</strong>γοράσου<strong>μ</strong><strong>ε</strong> πρωτοχρονιάτικο λ<strong>α</strong>χ<strong>ε</strong>ίο»<br />
κ<strong>α</strong>ι στο τρίτο, <strong>μ</strong><strong>ε</strong> οργή κ<strong>α</strong>ι <strong>α</strong>γ<strong>α</strong>νάκτηση γι<strong>α</strong><br />
τις πλ<strong>α</strong>στές <strong>ε</strong>ντυπώσ<strong>ε</strong>ις που της δη<strong>μ</strong>ιούργησ<strong>ε</strong><br />
η υπ<strong>ε</strong>ρπώληση <strong>μ</strong>ι<strong>α</strong>ς <strong>α</strong>ν<strong>α</strong>ποτ<strong>ε</strong>λ<strong>ε</strong>σ<strong>μ</strong><strong>α</strong>τικής<br />
δι<strong>α</strong>γνωστικής <strong>μ</strong><strong>ε</strong>θόδου.<br />
Το <strong>ε</strong>ρώτη<strong>μ</strong><strong>α</strong> που τίθ<strong>ε</strong>τ<strong>α</strong>ι ά<strong>μ</strong><strong>ε</strong>σ<strong>α</strong> <strong>ε</strong>ίν<strong>α</strong>ι,<br />
ποι<strong>α</strong> <strong>α</strong>πό τις π<strong>α</strong>ρ<strong>α</strong>πάνω δηλώσ<strong>ε</strong>ις <strong>ε</strong>ίν<strong>α</strong>ι<br />
<strong>α</strong>ληθινή. Η <strong>α</strong>πάντηση <strong>ε</strong>ίν<strong>α</strong>ι τουλάχιστον<br />
<strong>α</strong>πογοητ<strong>ε</strong>υτική: Όλ<strong>ε</strong>ς! Συγκ<strong>ε</strong>κρι<strong>μ</strong>έν<strong>α</strong>,<br />
οι δύο πρώτ<strong>ε</strong>ς λέν<strong>ε</strong> το ίδιο πράγ<strong>μ</strong><strong>α</strong><br />
<strong>μ</strong><strong>ε</strong> δι<strong>α</strong>φορ<strong>ε</strong>τικά λόγι<strong>α</strong>, <strong>α</strong>νάλογ<strong>α</strong> <strong>μ</strong><strong>ε</strong><br />
το <strong>α</strong>ν το ζητού<strong>μ</strong><strong>ε</strong>νο <strong>ε</strong>ίν<strong>α</strong>ι ο <strong>ε</strong>ντυπωσι<strong>α</strong>σ<strong>μ</strong>ός<br />
του <strong>α</strong>ν<strong>α</strong>γνώστη ή όχι. Tο 30%<br />
<strong>α</strong>π<strong>α</strong>ντά<strong>ε</strong>ι στο <strong>ε</strong>ρώτη<strong>μ</strong><strong>α</strong> «<strong>μ</strong><strong>ε</strong> δ<strong>ε</strong>δο<strong>μ</strong>ένο<br />
ότι πάσχω <strong>α</strong>πό κ<strong>α</strong>ρκίνο του <strong>μ</strong><strong>α</strong>στού,<br />
πόσο λιγότ<strong>ε</strong>ρ<strong>ε</strong>ς πιθ<strong>α</strong>νότητ<strong>ε</strong>ς έχω ν<strong>α</strong><br />
π<strong>ε</strong>θάνω <strong>α</strong>πό <strong>α</strong>υτό, <strong>α</strong>ν ο κ<strong>α</strong>ρκίνος <strong>μ</strong>ου<br />
<strong>α</strong>νιχν<strong>ε</strong>ύτηκ<strong>ε</strong> <strong>μ</strong><strong>ε</strong> <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong>;», <strong>ε</strong>νώ<br />
το 3 στις 2.000 <strong>α</strong>π<strong>α</strong>ντά<strong>ε</strong>ι στο <strong>ε</strong>ρώτη<strong>μ</strong><strong>α</strong>,<br />
«<strong>α</strong>ν <strong>ε</strong>ί<strong>μ</strong><strong>α</strong>ι <strong>μ</strong>ί<strong>α</strong> τυπική γυν<strong>α</strong>ίκ<strong>α</strong>, πόσο<br />
Ασκήσ<strong>ε</strong>ις υγ<strong>ε</strong>ιονο<strong>μ</strong>ικής π<strong>ε</strong>ιθ<strong>α</strong>ρχί<strong>α</strong>ς…<br />
θ<strong>α</strong> <strong>ε</strong>λ<strong>α</strong>ττωθ<strong>ε</strong>ί η πιθ<strong>α</strong>νότητ<strong>α</strong> ν<strong>α</strong> π<strong>ε</strong>θάνω<br />
<strong>α</strong>πό κ<strong>α</strong>ρκίνο του <strong>μ</strong><strong>α</strong>στού κάνοντ<strong>α</strong>ς<br />
<strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong> κάθ<strong>ε</strong> έτος;». Η τρίτη πρότ<strong>α</strong>ση,<br />
η οποί<strong>α</strong> θ<strong>α</strong> <strong>α</strong>ν<strong>α</strong>λυθ<strong>ε</strong>ί π<strong>α</strong>ρ<strong>α</strong>κάτω,<br />
έκ<strong>α</strong>ν<strong>ε</strong> δυν<strong>α</strong><strong>μ</strong>ικά την <strong>ε</strong><strong>μ</strong>φάνισή της τ<strong>α</strong><br />
τ<strong>ε</strong>λ<strong>ε</strong>υτ<strong>α</strong>ί<strong>α</strong> χρόνι<strong>α</strong> κ<strong>α</strong>ι ήδη προκ<strong>α</strong>λ<strong>ε</strong>ί<br />
ισχυρούς κλυδωνισ<strong>μ</strong>ούς στο οικοδό<strong>μ</strong>η<strong>μ</strong><strong>α</strong><br />
της προληπτικής ι<strong>α</strong>τρικής, <strong>μ</strong><strong>ε</strong><br />
πρώτο θύ<strong>μ</strong><strong>α</strong> την <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong>.<br />
Γι<strong>α</strong> ν<strong>α</strong> γίν<strong>ε</strong>ι <strong>α</strong>ντιληπτό το <strong>μ</strong>έγ<strong>ε</strong>θος<br />
της δι<strong>α</strong>φωνί<strong>α</strong>ς, πρέπ<strong>ε</strong>ι ν<strong>α</strong> <strong>α</strong>ν<strong>α</strong>φέρου<strong>μ</strong><strong>ε</strong><br />
ότι, <strong>μ</strong>έχρι σή<strong>μ</strong><strong>ε</strong>ρ<strong>α</strong> έχουν δι<strong>ε</strong>ξ<strong>α</strong>χθ<strong>ε</strong>ί<br />
<strong>ε</strong>πτά <strong>μ</strong><strong>ε</strong>γάλ<strong>ε</strong>ς κλινικές <strong>μ</strong><strong>ε</strong>λέτ<strong>ε</strong>ς <strong>α</strong>ξιολόγησης<br />
της <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong>ς, στις οποί<strong>ε</strong>ς<br />
συ<strong>μ</strong><strong>μ</strong><strong>ε</strong>τ<strong>ε</strong>ίχ<strong>α</strong>ν συνολικά <strong>μ</strong>ισό <strong>ε</strong>κ<strong>α</strong>το<strong>μ</strong><strong>μ</strong>ύριο<br />
γυν<strong>α</strong>ίκ<strong>ε</strong>ς κ<strong>α</strong>ι <strong>α</strong>κό<strong>μ</strong><strong>α</strong> η ι<strong>α</strong>τρική<br />
<strong>ε</strong>τυ<strong>μ</strong>ηγορί<strong>α</strong> δ<strong>ε</strong>ν έχ<strong>ε</strong>ι <strong>ε</strong>κδοθ<strong>ε</strong>ί.<br />
Κάθ<strong>ε</strong> <strong>μ</strong>ι<strong>α</strong> κλινική δοκι<strong>μ</strong>ή πυροδοτούσ<strong>ε</strong><br />
έν<strong>α</strong> έντονο κύ<strong>μ</strong><strong>α</strong> <strong>α</strong><strong>μ</strong>φισβητήσ<strong>ε</strong>ων<br />
κ<strong>α</strong>ι <strong>α</strong>ντ<strong>ε</strong>γκλήσ<strong>ε</strong>ων. Ως π<strong>α</strong>ράδ<strong>ε</strong>ιγ<strong>μ</strong><strong>α</strong><br />
<strong>α</strong>ν<strong>α</strong>φέρου<strong>μ</strong><strong>ε</strong> την π<strong>ε</strong>ριβόητη <strong>μ</strong><strong>ε</strong>λέτη<br />
των δύο Κο<strong>μ</strong>ητ<strong>ε</strong>ιών (Two Counties<br />
Trial), στην οποί<strong>α</strong> συ<strong>μ</strong><strong>μ</strong><strong>ε</strong>τ<strong>ε</strong>ίχ<strong>α</strong>ν <strong>13</strong>0.000<br />
Σουηδέζ<strong>ε</strong>ς <strong>α</strong>πό τις κο<strong>μ</strong>ητ<strong>ε</strong>ί<strong>ε</strong>ς Koppaberg<br />
κ<strong>α</strong>ι Ostergotland. Βρέθηκ<strong>ε</strong> ότι, η <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong><br />
<strong>ε</strong>λάττων<strong>ε</strong> την σχ<strong>ε</strong>τική θνητότητ<strong>α</strong><br />
<strong>α</strong>πό κ<strong>α</strong>ρκίνο του <strong>μ</strong><strong>α</strong>στού κ<strong>α</strong>τά 40%!<br />
Κ<strong>α</strong>ι ό<strong>μ</strong>ως, π<strong>α</strong>ρά το <strong>ε</strong>ντυπωσι<strong>α</strong>κό <strong>α</strong>υτό<br />
ποσοστό, η συνολική θνητότητ<strong>α</strong> <strong>μ</strong><strong>ε</strong>τ<strong>α</strong>ξύ<br />
των δύο ο<strong>μ</strong>άδων δ<strong>ε</strong>ν διέφ<strong>ε</strong>ρ<strong>ε</strong> κ<strong>α</strong>θόλου.<br />
Μ<strong>ε</strong> άλλ<strong>α</strong> λόγι<strong>α</strong>, <strong>μ</strong>πορ<strong>ε</strong>ί οι γυν<strong>α</strong>ίκ<strong>ε</strong>ς<br />
που υποβάλλοντ<strong>α</strong>ν σ<strong>ε</strong> <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong><br />
ν<strong>α</strong> πέθ<strong>α</strong>ιν<strong>α</strong>ν σ<strong>ε</strong> <strong>μ</strong>ικρότ<strong>ε</strong>ρο ποσοστό <strong>α</strong>πό<br />
κ<strong>α</strong>ρκίνο του <strong>μ</strong><strong>α</strong>στού, <strong>α</strong>λλά <strong>ε</strong>ίχ<strong>α</strong>ν <strong>α</strong>υξη<strong>μ</strong>έν<strong>ε</strong>ς<br />
πιθ<strong>α</strong>νότητ<strong>ε</strong>ς ν<strong>α</strong> π<strong>ε</strong>θάνουν <strong>α</strong>πό<br />
άλλ<strong>ε</strong>ς <strong>α</strong>ιτί<strong>ε</strong>ς, γ<strong>ε</strong>γονός που οδήγησ<strong>ε</strong> τον<br />
<strong>α</strong><strong>ε</strong>ί<strong>μ</strong>νηστο κ<strong>α</strong>θηγητή του Trinity College,<br />
Petr Skrabanek (<strong>μ</strong>ι<strong>α</strong> <strong>α</strong>πό τις πιο <strong>ε</strong>πηρ<strong>ε</strong><strong>α</strong>στικές<br />
φιγούρ<strong>ε</strong>ς στο χώρο της προληπτικής<br />
ι<strong>α</strong>τρικής κ<strong>α</strong>ι συγγρ<strong>α</strong>φέ<strong>α</strong> του<br />
συγκλονιστικού Follies and Fallacies<br />
in Medicine- Π<strong>α</strong>ρ<strong>α</strong>λογισ<strong>μ</strong>οί κ<strong>α</strong>ι Πλάν<strong>ε</strong>ς<br />
στην Ι<strong>α</strong>τρική) ν<strong>α</strong> δηλώσ<strong>ε</strong>ι ότι, «σ<strong>ε</strong><br />
<strong>μ</strong>ί<strong>α</strong> <strong>μ</strong><strong>ε</strong>λέτη που συ<strong>μ</strong><strong>μ</strong><strong>ε</strong>τ<strong>ε</strong>ίχ<strong>α</strong>ν <strong>13</strong>0.000<br />
γυν<strong>α</strong>ίκ<strong>ε</strong>ς δ<strong>ε</strong>ν σώθηκ<strong>ε</strong> ούτ<strong>ε</strong> <strong>μ</strong>ί<strong>α</strong> ζωή»<br />
(Skrabanek P. The debate over mass<br />
Οι οδηγί<strong>ε</strong>ς της Ελληνικής Ετ<strong>α</strong>ιρ<strong>ε</strong>ί<strong>α</strong>ς Μ<strong>α</strong>στολογί<strong>α</strong>ς (ΕΕΜ) <strong>ε</strong>ίν<strong>α</strong>ι σ<strong>α</strong>φ<strong>ε</strong>ίς: κάθ<strong>ε</strong> γυν<strong>α</strong>ίκ<strong>α</strong> πάνω άνω των 40 <strong>ε</strong>τών πρέπ<strong>ε</strong>ι ν<strong>α</strong><br />
υποβάλλ<strong>ε</strong>τ<strong>α</strong>ι κάθ<strong>ε</strong> χρόνο σ<strong>ε</strong> προληπτική <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong>. Αντίθ<strong>ε</strong>τ<strong>α</strong>, σχ<strong>ε</strong>δόν όλ<strong>ε</strong>ς οι χώρ<strong>ε</strong>ς της ΕΕ <strong>ε</strong>φ<strong>α</strong>ρ<strong>μ</strong>όζουν πρόγρ<strong>α</strong><strong>μ</strong><strong>μ</strong><strong>α</strong><br />
πληθυσ<strong>μ</strong>ι<strong>α</strong>κού <strong>ε</strong>λέγχου σ<strong>ε</strong> γυν<strong>α</strong>ίκ<strong>ε</strong>ς ηλικί<strong>α</strong>ς 50 έως 69 <strong>ε</strong>τών (<strong>μ</strong><strong>ε</strong> <strong>α</strong>το<strong>μ</strong>ική πρόσκληση <strong>α</strong>νά δύο έτη). Οι συστάσ<strong>ε</strong>ις της ΕΕΜ<br />
θ<strong>ε</strong>ωρούντ<strong>α</strong>ι υπ<strong>ε</strong>ρβολικές κ<strong>α</strong>ι <strong>ε</strong>ίν<strong>α</strong>ι <strong>ε</strong>κτός γρ<strong>α</strong><strong>μ</strong><strong>μ</strong>ής <strong>μ</strong><strong>ε</strong> <strong>α</strong>υτές της Συ<strong>μ</strong>βουλ<strong>ε</strong>υτικής Επιτροπής της Ευρωπ<strong>α</strong>ϊκής Ένωσης γι<strong>α</strong><br />
την Πρόληψη του Κ<strong>α</strong>ρκίνου, η οποί<strong>α</strong> <strong>α</strong>πό τον Δ<strong>ε</strong>κέ<strong>μ</strong>βριο του 1999 έχ<strong>ε</strong>ι συστήσ<strong>ε</strong>ι ως ηλικί<strong>α</strong> έν<strong>α</strong>ρξης της <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong>ς τ<strong>α</strong><br />
50 χρόνι<strong>α</strong>. Όπως <strong>α</strong>ν<strong>α</strong>φέρ<strong>ε</strong>τ<strong>α</strong>ι στη π<strong>α</strong>ράγρ<strong>α</strong>φο 4.3.1 του κ<strong>ε</strong>ι<strong>μ</strong>ένου, «οι δυσ<strong>μ</strong><strong>ε</strong>ν<strong>ε</strong>ίς συνέπ<strong>ε</strong>ι<strong>ε</strong>ς της <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong>ς σ<strong>ε</strong> γυν<strong>α</strong>ίκ<strong>ε</strong>ς<br />
ηλικί<strong>α</strong>ς 40-49 <strong>ε</strong>τών ίσως ν<strong>α</strong> <strong>μ</strong>ην <strong>ε</strong>ίν<strong>α</strong>ι <strong>α</strong><strong>μ</strong><strong>ε</strong>λητέ<strong>ε</strong>ς, λόγω της χ<strong>α</strong><strong>μ</strong>ηλής δι<strong>α</strong>γνωστικής <strong>α</strong>ξί<strong>α</strong>ς της <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong>ς σ’ <strong>α</strong>υτήν<br />
την ηλικι<strong>α</strong>κή ο<strong>μ</strong>άδ<strong>α</strong>, την πιθ<strong>α</strong>νή <strong>α</strong>νίχν<strong>ε</strong>υση <strong>μ</strong>η <strong>ε</strong>ξ<strong>ε</strong>λισσό<strong>μ</strong><strong>ε</strong>νων κ<strong>α</strong>ρκίνων κ<strong>α</strong>ι τον υψηλό κίνδυνο που <strong>ε</strong>νέχ<strong>ε</strong>ι η <strong>α</strong>κτινοβολί<strong>α</strong>».<br />
Στις συστάσ<strong>ε</strong>ις προς τ<strong>α</strong> κράτη <strong>μ</strong>έλη <strong>α</strong>ν<strong>α</strong>φέρ<strong>ε</strong>τ<strong>α</strong>ι ρητά ότι, «ότ<strong>α</strong>ν προσφέρ<strong>ε</strong>τ<strong>α</strong>ι προσυ<strong>μ</strong>πτω<strong>μ</strong><strong>α</strong>τικός έλ<strong>ε</strong>γχος <strong>μ</strong><strong>ε</strong> <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong><br />
πρέπ<strong>ε</strong>ι ν<strong>α</strong> κ<strong>α</strong>λούντ<strong>α</strong>ι <strong>μ</strong>όνο γυν<strong>α</strong>ίκ<strong>ε</strong>ς ηλικί<strong>α</strong>ς 50-69 <strong>ε</strong>τών». Σ<strong>ε</strong> <strong>α</strong>ντίστοιχ<strong>α</strong> συ<strong>μ</strong>π<strong>ε</strong>ράσ<strong>μ</strong><strong>α</strong>τ<strong>α</strong> κ<strong>α</strong>τέληξ<strong>ε</strong> το 2007 κ<strong>α</strong>ι το<br />
Α<strong>μ</strong><strong>ε</strong>ρικ<strong>α</strong>νικό Κολλέγιο Ι<strong>α</strong>τρών (American College of Physicians). Πίσω <strong>α</strong>πό <strong>α</strong>υτήν την Ελληνική υπ<strong>ε</strong>ρβολή βρίσκ<strong>ε</strong>τ<strong>α</strong>ι <strong>μ</strong>ί<strong>α</strong><br />
β<strong>α</strong>λκ<strong>α</strong>νικής κοπής υπ<strong>ε</strong>ρ<strong>α</strong>ντίδρ<strong>α</strong>ση: η Ελλάδ<strong>α</strong> (<strong>μ</strong><strong>α</strong>ζί <strong>μ</strong><strong>ε</strong> την Αυστρί<strong>α</strong>) <strong>ε</strong>ίν<strong>α</strong>ι η <strong>μ</strong>όνη χώρ<strong>α</strong> της ΕΕ (των 25), η οποί<strong>α</strong> δ<strong>ε</strong>ν προσκ<strong>α</strong>λ<strong>ε</strong>ί<br />
σ<strong>ε</strong> οργ<strong>α</strong>νω<strong>μ</strong>ένη βάση (<strong>μ</strong><strong>ε</strong> πρόσκληση σ<strong>ε</strong> νοσοκο<strong>μ</strong><strong>ε</strong>ίο, όπως οι υπόλοιπ<strong>ε</strong>ς χώρ<strong>ε</strong>ς) τον γυν<strong>α</strong>ικ<strong>ε</strong>ίο πληθυσ<strong>μ</strong>ό της γι<strong>α</strong><br />
<strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φικό έλ<strong>ε</strong>γχο. Αντ’ <strong>α</strong>υτού β<strong>α</strong>σίζ<strong>ε</strong>ι το πρόγρ<strong>α</strong><strong>μ</strong><strong>μ</strong>ά της σ<strong>ε</strong> <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φικά γιουρούσι<strong>α</strong> σ<strong>ε</strong> πλ<strong>α</strong>τ<strong>ε</strong>ί<strong>ε</strong>ς χωριών, κοινοτήτων<br />
κ<strong>α</strong>ι δή<strong>μ</strong>ων. Έτσι, <strong>α</strong>ποφάσισ<strong>ε</strong>, κ<strong>α</strong>τά τρόπο κω<strong>μ</strong>ικοτρ<strong>α</strong>γικό, ν<strong>α</strong> υπ<strong>ε</strong>ρ<strong>α</strong>ν<strong>α</strong>πληρώσ<strong>ε</strong>ι την οργ<strong>α</strong>νωτική της <strong>α</strong>δυν<strong>α</strong><strong>μ</strong>ί<strong>α</strong>, κ<strong>α</strong>τ<strong>ε</strong>βάζοντ<strong>α</strong>ς<br />
το ηλικι<strong>α</strong>κό όριο σύστ<strong>α</strong>σης γι<strong>α</strong> <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong> στ<strong>α</strong> 40 έτη. Ακριβοί στ<strong>α</strong> πίτουρ<strong>α</strong> κ<strong>α</strong>ι φτηνοί στ<strong>α</strong> <strong>α</strong>λ<strong>ε</strong>ύρι<strong>α</strong>.<br />
ΜΑΡΤΙΟΣ 20<strong>09</strong> / TEYXOΣ <strong><strong>17</strong>2</strong> / MEDICAL EXPRESS / 79
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