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> 81<br />
Mammography-Screened Patients of<br />
a Natural Cohort with Breast Cancer.<br />
Arch Intern Med. 2000. 160: <strong>11</strong><strong>09</strong>-<br />
<strong>11</strong>15). Αποτέλ<strong>ε</strong>σ<strong>μ</strong><strong>α</strong> της <strong>α</strong>νίχν<strong>ε</strong>υσης κ<strong>α</strong>ι<br />
<strong>α</strong>υτών των όγκων <strong>ε</strong>ίν<strong>α</strong>ι η ρ<strong>α</strong>γδ<strong>α</strong>ί<strong>α</strong> <strong>α</strong>ύξηση<br />
των π<strong>ε</strong>ριστ<strong>α</strong>τικών κ<strong>α</strong>ρκίνου του <strong>μ</strong><strong>α</strong>στού<br />
τις τ<strong>ε</strong>λ<strong>ε</strong>υτ<strong>α</strong>ί<strong>ε</strong>ς δ<strong>ε</strong>κ<strong>α</strong><strong>ε</strong>τί<strong>ε</strong>ς: <strong>μ</strong><strong>ε</strong>λέτη <strong>α</strong>πό το<br />
Νορβηγικό Ινστιτούτο Δη<strong>μ</strong>όσι<strong>α</strong>ς Υγ<strong>ε</strong>ί<strong>α</strong>ς<br />
έδ<strong>ε</strong>ιξ<strong>ε</strong> ότι, στη χώρ<strong>α</strong> <strong>α</strong>υτή, η <strong>α</strong>ύξηση<br />
ήτ<strong>α</strong>ν π<strong>ε</strong>ρίπου 50% στις ηλικί<strong>ε</strong>ς που υποβάλλοντ<strong>α</strong>ι<br />
σ<strong>ε</strong> <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong> (50-69 χρονών).<br />
Σύ<strong>μ</strong>φων<strong>α</strong> <strong>μ</strong><strong>ε</strong> τους Νορβηγούς <strong>ε</strong>πιστή<strong>μ</strong>ον<strong>ε</strong>ς<br />
έν<strong>α</strong> 30% <strong>α</strong>υτών των κ<strong>α</strong>ρκίνων<br />
<strong>α</strong>ποτ<strong>ε</strong>λ<strong>ε</strong>ίτ<strong>α</strong>ι <strong>α</strong>πό όγκους που ουσι<strong>α</strong>στικά<br />
δ<strong>ε</strong>ν θ<strong>α</strong> γίνοντ<strong>α</strong>ν ποτέ κλινικά <strong>α</strong>ντιληπτοί<br />
κ<strong>α</strong>ι άρ<strong>α</strong> δ<strong>ε</strong> θ<strong>α</strong> τ<strong>α</strong>λ<strong>α</strong>ιπωρούσ<strong>α</strong>ν ποτέ<br />
τις γυν<strong>α</strong>ίκ<strong>ε</strong>ς, <strong>α</strong>ν <strong>α</strong>υτές δ<strong>ε</strong>ν υποβάλλοντ<strong>α</strong>ν<br />
σ<strong>ε</strong> <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong>.(Zahl PH, Heine<br />
B, Maehlen J. Incidence of breast cancer<br />
in Norway and Sweden durong introduction<br />
of nationwide screening: prospective<br />
cohort study. BMJ. 2004.328: 921-924).<br />
Η συγκ<strong>ε</strong>κρι<strong>μ</strong>ένη πρ<strong>α</strong>γ<strong>μ</strong><strong>α</strong>τικότητ<strong>α</strong> <strong>α</strong>ντ<strong>α</strong>ν<strong>α</strong>κλάτ<strong>α</strong>ι<br />
κ<strong>α</strong>ι στ<strong>α</strong> νού<strong>μ</strong><strong>ε</strong>ρ<strong>α</strong>: οι <strong>ε</strong>ρ<strong>ε</strong>υνητές<br />
της Cochrane Review <strong>α</strong>πέδ<strong>ε</strong>ιξ<strong>α</strong>ν<br />
ότι, ο υπ<strong>ε</strong>ρ<strong>ε</strong>ντοπισ<strong>μ</strong>ός τέτοιων, <strong>α</strong>λλά κ<strong>α</strong>ι<br />
άλλων κ<strong>α</strong>ρκίνων βρ<strong>α</strong>δ<strong>ε</strong>ί<strong>α</strong>ς <strong>α</strong>νάπτυξης,<br />
έχ<strong>ε</strong>ι οδηγήσ<strong>ε</strong>ι σ<strong>ε</strong> <strong>α</strong>ύξηση των <strong>μ</strong><strong>α</strong>στ<strong>ε</strong>κτο<strong>μ</strong>ών<br />
κ<strong>α</strong>ι των <strong>α</strong>κτινοβολιών κ<strong>α</strong>τά 20 κ<strong>α</strong>ι<br />
30% <strong>α</strong>ντίστοιχ<strong>α</strong>. Κ<strong>α</strong>ι όλ<strong>α</strong> <strong>α</strong>υτά, π<strong>α</strong>ρά τις<br />
<strong>α</strong>φ<strong>ε</strong>λ<strong>ε</strong>ίς προσδοκί<strong>ε</strong>ς κ<strong>α</strong>ι <strong>α</strong>υτάρ<strong>ε</strong>σκ<strong>ε</strong>ς δι<strong>α</strong>β<strong>ε</strong>β<strong>α</strong>ιώσ<strong>ε</strong>ις<br />
των υγ<strong>ε</strong>ιονο<strong>μ</strong>ικών <strong>α</strong>ρχών<br />
ότι η πρώι<strong>μ</strong>η διάγνωση, λόγω <strong>ε</strong>ντοπισ<strong>μ</strong>ού<br />
κ<strong>α</strong>ρκίνων του <strong>μ</strong><strong>α</strong>στού σ<strong>ε</strong> <strong>α</strong>ρχική<br />
<strong>μ</strong>ορφή, θ<strong>α</strong> οδηγούσ<strong>ε</strong> σ<strong>ε</strong> <strong>μ</strong><strong>ε</strong>ίωση των πιο<br />
<strong>ε</strong>πιθ<strong>ε</strong>τικών <strong>μ</strong>ορφών θ<strong>ε</strong>ρ<strong>α</strong>π<strong>ε</strong>ί<strong>α</strong>ς. Χ<strong>α</strong>ρ<strong>α</strong>κτηριστικά<br />
<strong>α</strong>ν<strong>α</strong>φέρου<strong>μ</strong><strong>ε</strong> ότι στην Μ<strong>ε</strong>γάλη<br />
Βρ<strong>ε</strong>τ<strong>α</strong>νί<strong>α</strong> τ<strong>α</strong> π<strong>ε</strong>ριστ<strong>α</strong>τικά <strong>μ</strong><strong>α</strong>στ<strong>ε</strong>κτο<strong>μ</strong>ών<br />
γι<strong>α</strong> διηθητικούς κ<strong>α</strong>ρκίνους κ<strong>α</strong>ι γι<strong>α</strong><br />
in situ κ<strong>α</strong>ρκινώ<strong>μ</strong><strong>α</strong>τ<strong>α</strong> (βλέπ<strong>ε</strong> ΒΟΧ 4),<br />
Κλινικές Μ<strong>ε</strong>λέτ<strong>ε</strong>ς: Έτσι <strong>ε</strong>ίν<strong>α</strong>ι, <strong>α</strong>ν έτσι νο<strong>μ</strong>ίζ<strong>ε</strong>τ<strong>ε</strong>…<br />
<strong>α</strong>υξήθηκ<strong>α</strong>ν <strong>α</strong>πό το 1990 έως το 2001<br />
(π<strong>ε</strong>ρίοδος κ<strong>α</strong>θολικής υποβολής σ<strong>ε</strong> <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong>)<br />
κ<strong>α</strong>τά 36% κ<strong>α</strong>ι 422% <strong>α</strong>ντιστοίχως.<br />
(Douek M, Baum M. Mass breast<br />
screening: is there a hidden cost? Brit<br />
J Surg. 2003.90(Suppl 1) 14).<br />
Μ<strong>α</strong>κάριοι οι <strong>α</strong>γνοούντ<strong>ε</strong>ς…<br />
Ignorance is bliss λέ<strong>ε</strong>ι έν<strong>α</strong> τρ<strong>α</strong>γούδι,<br />
δηλ<strong>α</strong>δή η άγνοι<strong>α</strong> <strong>ε</strong>ίν<strong>α</strong>ι <strong>ε</strong>υτυχί<strong>α</strong>. Ο τίτλος<br />
<strong>α</strong>υτός βρίσκ<strong>ε</strong>ι <strong>α</strong>πόλυτη <strong>ε</strong>φ<strong>α</strong>ρ<strong>μ</strong>ογή<br />
στην π<strong>ε</strong>ρίπτωση της <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong>ς. Η<br />
<strong>α</strong>κρ<strong>α</strong>ί<strong>α</strong> <strong>μ</strong>ορφή του «σφάλ<strong>μ</strong><strong>α</strong>τος τ<strong>α</strong>χύτητ<strong>α</strong>ς<br />
<strong>ε</strong>ξέλιξης <strong>ε</strong>ίν<strong>α</strong>ι ότι, πιθ<strong>α</strong>νώς, η <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong><br />
<strong>α</strong>νιχν<strong>ε</strong>ύ<strong>ε</strong>ι όγκους, που έτσι κι<br />
<strong>α</strong>λλιώς θ<strong>α</strong> υποχωρούσ<strong>α</strong>ν <strong>α</strong>πό <strong>μ</strong>όνοι<br />
τους! Η ύπ<strong>α</strong>ρξη τέτοι<strong>α</strong>ς <strong>μ</strong>ορφής κ<strong>α</strong>ρκίνων<br />
<strong>α</strong>ποτ<strong>ε</strong>λ<strong>ε</strong>ί τον σκ<strong>ε</strong>λ<strong>ε</strong>τό στο ντουλάπι<br />
της προληπτικής ι<strong>α</strong>τρικής <strong>μ</strong>ι<strong>α</strong> κ<strong>α</strong>ι οδηγ<strong>ε</strong>ί<br />
υγι<strong>ε</strong>ίς <strong>α</strong>νθρώπους σ<strong>ε</strong> <strong>ε</strong>πιθ<strong>ε</strong>τική<br />
Γι<strong>α</strong> ν<strong>α</strong> γίν<strong>ε</strong>ι κ<strong>α</strong>τ<strong>α</strong>νοητή η <strong>α</strong>ιτί<strong>α</strong> της σύγχυσης θ<strong>α</strong> πάρου<strong>μ</strong><strong>ε</strong> ως π<strong>α</strong>ράδ<strong>ε</strong>ιγ<strong>μ</strong><strong>α</strong> την πρώτη σχ<strong>ε</strong>τική κλινική <strong>μ</strong><strong>ε</strong>λέτη που έγιν<strong>ε</strong> την<br />
δ<strong>ε</strong>κ<strong>α</strong><strong>ε</strong>τί<strong>α</strong> του ’60. Οι υγ<strong>ε</strong>ιονο<strong>μ</strong>ικές <strong>α</strong>ρχές της Νέ<strong>α</strong>ς Υόρκης, θέλοντ<strong>α</strong>ς ν<strong>α</strong> δουν κ<strong>α</strong>τά πόσον η τ<strong>α</strong>κτική <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong> θ<strong>α</strong> οδηγούσ<strong>ε</strong><br />
<strong>μ</strong>έσω της πρώι<strong>μ</strong>ης διάγνωσης σ<strong>ε</strong> <strong>ε</strong>λάττωση του <strong>α</strong>ριθ<strong>μ</strong>ού των θ<strong>α</strong>νάτων <strong>α</strong>πό κ<strong>α</strong>ρκίνο του <strong>μ</strong><strong>α</strong>στού, <strong>α</strong>ποφάσισ<strong>α</strong>ν ν<strong>α</strong> δι<strong>ε</strong>ξάγουν<br />
τη διάση<strong>μ</strong>η <strong>μ</strong><strong>ε</strong>λέτη HIP (Health Insurance Plan). Συγκέντρωσ<strong>α</strong>ν 60.000 υγι<strong>ε</strong>ίς γυν<strong>α</strong>ίκ<strong>ε</strong>ς κ<strong>α</strong>ι τις χώρισ<strong>α</strong>ν τυχ<strong>α</strong>ί<strong>α</strong>, έτσι<br />
ώστ<strong>ε</strong> ν<strong>α</strong> δη<strong>μ</strong>ιουργηθούν δύο ο<strong>μ</strong>ο<strong>ε</strong>ιδ<strong>ε</strong>ίς ο<strong>μ</strong>άδ<strong>ε</strong>ς των 30.000 <strong>α</strong>τό<strong>μ</strong>ων έκ<strong>α</strong>στη. Στην πρώτη ο<strong>μ</strong>άδ<strong>α</strong> οι γυν<strong>α</strong>ίκ<strong>ε</strong>ς υποβάλλοντ<strong>α</strong>ν<br />
<strong>ε</strong>πί πέντ<strong>ε</strong> χρόνι<strong>α</strong> σ<strong>ε</strong> <strong>ε</strong>τήσι<strong>α</strong> <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong> (ο<strong>μ</strong>άδ<strong>α</strong> π<strong>α</strong>ρέ<strong>μ</strong>β<strong>α</strong>σης, στη συγκ<strong>ε</strong>κρι<strong>μ</strong>ένη π<strong>ε</strong>ρίπτωση ο<strong>μ</strong>άδ<strong>α</strong> <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong>ς), <strong>ε</strong>νώ<br />
στη δ<strong>ε</strong>ύτ<strong>ε</strong>ρη οι γυν<strong>α</strong>ίκ<strong>ε</strong>ς δ<strong>ε</strong>ν <strong>ε</strong>ξ<strong>ε</strong>τάζοντ<strong>α</strong>ν κ<strong>α</strong>νονικά <strong>ε</strong>κτός κ<strong>α</strong>ι <strong>α</strong>ν <strong>α</strong>ισθάνοντ<strong>α</strong>ν κάποιο ύποπτο σύ<strong>μ</strong>πτω<strong>μ</strong><strong>α</strong> (ο<strong>μ</strong>άδ<strong>α</strong> <strong>ε</strong>λέγχου).<br />
Οι <strong>ε</strong>ρ<strong>ε</strong>υνητές βρήκ<strong>α</strong>ν ότι, <strong>μ</strong><strong>ε</strong>τά <strong>α</strong>πό δέκ<strong>α</strong> χρόνι<strong>α</strong> 147 γυν<strong>α</strong>ίκ<strong>ε</strong>ς έχ<strong>α</strong>σ<strong>α</strong>ν τη ζωή τους <strong>α</strong>πό κ<strong>α</strong>ρκίνο του <strong>μ</strong><strong>α</strong>στού στην ο<strong>μ</strong>άδ<strong>α</strong><br />
της <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong>ς κ<strong>α</strong>ι 193 στην ο<strong>μ</strong>άδ<strong>α</strong> <strong>ε</strong>λέγχου. Ας δού<strong>μ</strong><strong>ε</strong> τώρ<strong>α</strong> πώς λ<strong>ε</strong>ιτουργ<strong>ε</strong>ί η δη<strong>μ</strong>ιουργική στ<strong>α</strong>τιστική κ<strong>α</strong>ι πώς το π<strong>α</strong>ρ<strong>α</strong>πάνω<br />
<strong>α</strong>ποτέλ<strong>ε</strong>σ<strong>μ</strong><strong>α</strong> <strong>μ</strong>πορ<strong>ε</strong>ί ν<strong>α</strong> κοινοποιηθ<strong>ε</strong>ί στον κόσ<strong>μ</strong>ο ως ι<strong>α</strong>τρική <strong>ε</strong>π<strong>α</strong>νάστ<strong>α</strong>ση ή ως <strong>α</strong>σή<strong>μ</strong><strong>α</strong>ντο <strong>ε</strong>ύρη<strong>μ</strong><strong>α</strong>, <strong>α</strong>νάλογ<strong>α</strong> <strong>μ</strong><strong>ε</strong> τις <strong>ε</strong>πιδιώξ<strong>ε</strong>ις<br />
του π<strong>α</strong>ρουσι<strong>α</strong>στή. Τ<strong>α</strong> στοιχ<strong>ε</strong>ί<strong>α</strong> <strong>μ</strong><strong>α</strong>ς δ<strong>ε</strong>ίχνουν ότι, 46 λιγότ<strong>ε</strong>ρ<strong>ε</strong>ς γυν<strong>α</strong>ίκ<strong>ε</strong>ς πέθ<strong>α</strong>ν<strong>α</strong>ν <strong>α</strong>πό κ<strong>α</strong>ρκίνο του <strong>μ</strong><strong>α</strong>στού στην ο<strong>μ</strong>άδ<strong>α</strong><br />
της <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong>ς. 46 διά 193 <strong>μ</strong><strong>α</strong>ς κάν<strong>ε</strong>ι π<strong>ε</strong>ρίπου 0,3, πράγ<strong>μ</strong><strong>α</strong> που ση<strong>μ</strong><strong>α</strong>ίν<strong>ε</strong>ι ότι, πέθ<strong>α</strong>ν<strong>α</strong>ν 30% λιγότ<strong>ε</strong>ρ<strong>ε</strong>ς γυν<strong>α</strong>ίκ<strong>ε</strong>ς <strong>α</strong>πό<br />
την ο<strong>μ</strong>άδ<strong>α</strong> της <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong>ς σ<strong>ε</strong> σχέση <strong>μ</strong><strong>ε</strong> την ο<strong>μ</strong>άδ<strong>α</strong> <strong>ε</strong>λέγχου, δηλ<strong>α</strong>δή το νού<strong>μ</strong><strong>ε</strong>ρο που <strong>α</strong>ν<strong>α</strong>φέρθηκ<strong>ε</strong> στην πρότ<strong>α</strong>ση 1.<br />
Υπάρχ<strong>ε</strong>ι ό<strong>μ</strong>ως κ<strong>α</strong>ι έν<strong>α</strong>ς άλλος τρόπος <strong>α</strong>νάγνωσης των <strong>α</strong>ποτ<strong>ε</strong>λ<strong>ε</strong>σ<strong>μ</strong>άτων, σ<strong>α</strong>φώς πιο <strong>α</strong><strong>μ</strong><strong>ε</strong>ίλικτος κ<strong>α</strong>ι πρ<strong>α</strong>γ<strong>μ</strong><strong>α</strong>τικός, <strong>α</strong>υτός των<br />
<strong>α</strong>πόλυτων <strong>μ</strong><strong>ε</strong>γ<strong>ε</strong>θών: <strong>α</strong>πό τις 30.000 γυν<strong>α</strong>ίκ<strong>ε</strong>ς σ<strong>ε</strong> δέκ<strong>α</strong> χρόνι<strong>α</strong> σώθηκ<strong>α</strong>ν 46. Αν πολλ<strong>α</strong>πλ<strong>α</strong>σιάσ<strong>ε</strong>τ<strong>ε</strong> το 46 <strong>ε</strong>πί 2.000 κ<strong>α</strong>ι το<br />
δι<strong>α</strong>ιρέσ<strong>ε</strong>τ<strong>ε</strong> διά του 30.000, βγάζ<strong>ε</strong>τ<strong>ε</strong> π<strong>ε</strong>ρίπου 3, δηλ<strong>α</strong>δή πρέπ<strong>ε</strong>ι ν<strong>α</strong> υποβάλλοντ<strong>α</strong>ι σ<strong>ε</strong> <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong> 2000 γυν<strong>α</strong>ίκ<strong>ε</strong>ς <strong>ε</strong>πί 10 χρόνι<strong>α</strong><br />
γι<strong>α</strong> ν<strong>α</strong> σωθούν 3, δηλ<strong>α</strong>δή το νού<strong>μ</strong><strong>ε</strong>ρο της πρότ<strong>α</strong>σης 2. Βέβ<strong>α</strong>ι<strong>α</strong> θ<strong>α</strong> <strong>μ</strong>πορούσ<strong>ε</strong> ν<strong>α</strong> ισχυριστ<strong>ε</strong>ί κ<strong>α</strong>ν<strong>ε</strong>ίς ότι, όσο «φτωχό» κ<strong>α</strong>ι<br />
<strong>α</strong>ν <strong>α</strong>κούγ<strong>ε</strong>τ<strong>α</strong>ι το 3 στις 2.000, <strong>α</strong>ν το <strong>α</strong>νάγ<strong>ε</strong>ι σ<strong>ε</strong> <strong>ε</strong>πίπ<strong>ε</strong>δο συνολικού πληθυσ<strong>μ</strong>ού, τότ<strong>ε</strong> σίγουρ<strong>α</strong> τ<strong>α</strong> νού<strong>μ</strong><strong>ε</strong>ρ<strong>α</strong> φ<strong>α</strong>ίνοντ<strong>α</strong>ι πιο <strong>α</strong>ισιόδοξ<strong>α</strong>.<br />
Δυστυχώς τ<strong>α</strong> πράγ<strong>μ</strong><strong>α</strong>τ<strong>α</strong> δ<strong>ε</strong>ν <strong>ε</strong>ίν<strong>α</strong>ι έτσι. Οι τυχ<strong>α</strong>ιοποιη<strong>μ</strong>έν<strong>ε</strong>ς κλινικές <strong>μ</strong><strong>ε</strong>λέτ<strong>ε</strong>ς <strong>μ</strong>πορ<strong>ε</strong>ί ν<strong>α</strong> <strong>ε</strong>ίν<strong>α</strong>ι ο <strong>α</strong>σφ<strong>α</strong>λέστ<strong>ε</strong>ρος τρόπος<br />
<strong>ε</strong>ξ<strong>α</strong>γωγής <strong>ε</strong>πιστη<strong>μ</strong>ονικών συ<strong>μ</strong>π<strong>ε</strong>ρ<strong>α</strong>σ<strong>μ</strong>άτων, <strong>α</strong>λλά τ<strong>α</strong>υτόχρον<strong>α</strong> <strong>ε</strong>ίν<strong>α</strong>ι κ<strong>α</strong>τ<strong>α</strong>πληκτικά <strong>ε</strong>πιρρ<strong>ε</strong>π<strong>ε</strong>ίς σ<strong>ε</strong> σφάλ<strong>μ</strong><strong>α</strong>τ<strong>α</strong> σχ<strong>ε</strong>δι<strong>α</strong>σ<strong>μ</strong>ού. Έν<strong>α</strong><br />
<strong>α</strong>πό τ<strong>α</strong> πιο συνηθισ<strong>μ</strong>έν<strong>α</strong> σφάλ<strong>μ</strong><strong>α</strong>τ<strong>α</strong> <strong>ε</strong>ίν<strong>α</strong>ι <strong>α</strong>υτό της <strong>α</strong>ποτυχί<strong>α</strong>ς ν<strong>α</strong> κ<strong>α</strong>τ<strong>α</strong>ν<strong>ε</strong><strong>μ</strong>ηθούν τυχ<strong>α</strong>ί<strong>α</strong> οι συ<strong>μ</strong><strong>μ</strong><strong>ε</strong>τέχοντ<strong>ε</strong>ς στις ο<strong>μ</strong>άδ<strong>ε</strong>ς π<strong>α</strong>ρέ<strong>μ</strong>β<strong>α</strong>σης<br />
ή <strong>ε</strong>λέγχου, ώστ<strong>ε</strong> ν<strong>α</strong> δι<strong>α</strong>σφ<strong>α</strong>λιστ<strong>ε</strong>ί η <strong>α</strong>ντικ<strong>ε</strong>ι<strong>μ</strong><strong>ε</strong>νικότητ<strong>α</strong> των συ<strong>μ</strong>π<strong>ε</strong>ρ<strong>α</strong>σ<strong>μ</strong>άτων. Έν<strong>α</strong> τέτοιου <strong>ε</strong>ίδους σφάλ<strong>μ</strong><strong>α</strong> υπονό<strong>μ</strong><strong>ε</strong>υσ<strong>ε</strong><br />
την <strong>α</strong>ξιοπιστί<strong>α</strong> των <strong>ε</strong>υρη<strong>μ</strong>άτων της HIP: όπως φάνηκ<strong>ε</strong> <strong>α</strong>ργότ<strong>ε</strong>ρ<strong>α</strong>, η ο<strong>μ</strong>άδ<strong>α</strong> <strong>ε</strong>λέγχου πιθ<strong>α</strong>νώς ν<strong>α</strong> π<strong>ε</strong>ρι<strong>ε</strong>ίχ<strong>ε</strong> <strong>ε</strong>ξ’ <strong>α</strong>ρχής π<strong>ε</strong>ρισσότ<strong>ε</strong>ρ<strong>ε</strong>ς<br />
γυν<strong>α</strong>ίκ<strong>ε</strong>ς που έπ<strong>α</strong>σχ<strong>α</strong>ν ήδη <strong>α</strong>πό κ<strong>α</strong>ρκίνο του <strong>μ</strong><strong>α</strong>στού. Όπως <strong>α</strong>ν<strong>α</strong>φέρθηκ<strong>ε</strong> χ<strong>α</strong>ρ<strong>α</strong>κτηριστικά, 25 τέτοι<strong>ε</strong>ς γυν<strong>α</strong>ίκ<strong>ε</strong>ς<br />
π<strong>α</strong>ρ<strong>α</strong>πάνω ν<strong>α</strong> υπήρχ<strong>α</strong>ν στην ο<strong>μ</strong>άδ<strong>α</strong> <strong>ε</strong>λέγχου ήτ<strong>α</strong>ν ικ<strong>α</strong>νές ν<strong>α</strong> <strong>α</strong>κυρώσουν κάθ<strong>ε</strong> <strong>ε</strong>υνοϊκό π<strong>ε</strong>ρί <strong>μ</strong><strong>α</strong>στογρ<strong>α</strong>φί<strong>α</strong>ς <strong>ε</strong>ύρη<strong>μ</strong><strong>α</strong> (David<br />
Plotkin, Good News and Bad News About Breast Cancer, The Atlantic, June 1998).<br />
ΜΑΡΤΙΟΣ 20<strong>09</strong> / TEYXOΣ <strong><strong>17</strong>2</strong> / MEDICAL EXPRESS / 81
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