中新健康丨专家:防治肺癌,四类高危人群需重点筛查|丝袜老师办公室里做好紧好爽

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  中新网北京11月30日电(记者 赵方园)“肺癌防治,既要重视预防,也要科学治疗。”11月27日,由中国健康促进与教育协会举办的中国健康知识传播激励计划肺癌关注月(11月)专题访谈在北京举办。会上,同济大学附属东方医院肿瘤科主任、国际肺癌研究协会主席周彩存指出,预防是应对肺癌的第一道防线,远离明确的致癌因素,有助于从源头降低患病风险。

  周彩存强调,吸烟是肺癌最主要的危险因素之一。吸烟量越大、起始吸烟年龄越早,患病风险越高;同时,抽烟越多,靶向治疗机会也少,得了肿瘤后发展也快,愈后情况也不好,因此尽早戒烟、避免二手烟暴露是关键。此外,还应避免长期接触粉尘、化学有害物质,关注空气质量,在污染天气做好防护,从生活细节降低肺癌诱因。

  针对筛查重点人群,周彩存明确了四类高危对象:长期吸烟者、有恶性肿瘤家族史者、有慢性肺部疾病或职业暴露史者,以及70岁左右的高龄人群。他建议此类人群定期进行低剂量螺旋CT筛查,以实现“早发现、早诊断、早治疗”。周彩存指出,早期肺癌经规范治疗后临床治愈率较高,低剂量螺旋CT作为目前最有效的筛查工具,能精准识别2-3毫米的微小病灶,避免因症状不明显而延误诊治。

  随着体检手段的进步,越来越多人发现肺部结节,由此产生的焦虑情绪十分普遍。对此,周彩存教授给出“安心指南”——小结节不等于肺癌;95%以上的肺部结节为良性;5毫米以下结节恶性概率仅1%-2%。

  他强调,结节良恶性需结合大小、形态、密度及个人病史综合判断,无需盲目恐慌。对于低风险人群(不吸烟、无家族史、结节形态规则),5毫米以下结节每2-3年随访一次即可;高风险人群则根据情况缩短至半年随访。若随访中发现结节增大或形态变化,及时就医干预,无需急于手术造成肺功能损伤。

  在治疗方面,周彩存强调应依据病情分期制定个性化方案。早期(Ⅰ期)肺癌术后治愈率可达80%-90%,中期患者部分有望通过新辅助免疫化疗等手段实现“降期”,晚期患者则有望通过精准治疗实现慢性病化管理。同时,随着国产药物疗效提升及相关政策支持,患者治疗负担逐步减轻,区域医疗能力的增强也为规范治疗提供了更好保障。(完)

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