Na sadaukar da wannan labarin ga dukkan mata da aka gayyata zuwa gwajin mammography da kuma waɗanda suke ƙaunarsu saboda an ci gaba da yi wa jama'a ƙarya, tsawon sama da shekaru 40. A cikin gayyatar zuwa tantancewa, an gaya wa mata cewa ta hanyar gano cutar kansa da wuri, tantancewa tana ceton rayuka kuma tana haifar da tiyata mara yawa.1,2 Zan nuna cewa dukkan maganganun guda uku ba daidai ba ne.
Har yanzu ana yi wa mata ƙarya, ta hanyar ƙungiyoyin ƙwararru, masu fafutukar tantancewa, masu binciken tantancewa, ƙungiyoyin agaji na ciwon daji, da kuma hukumomin lafiya na ƙasa.3-5 Ƙungiyar Ciwon Daji ta Amurka ta bayyana a cikin wani babban labari cewa "Mammography Yana Ceton Rayuka"4 da kuma ikirarin, ba tare da wani bayani ba, wanda sakamakon bincike na tsawon shekaru da dama ya nuna a sarari cewa matan da ke yin gwajin mammogram akai-akai ba sa buƙatar magunguna masu tsanani kamar tiyata don cire dukkan nonon (mastectomy).5
Nunawa Ba Ya Ceton Rayuka
A cikin gwaje-gwajen da aka gudanar bazuwar na gwajin mammography, rabon haɗarin mace-mace gaba ɗaya bayan shekaru 13 na bin diddigin cutar shine 0.99 (tazara amincewa 95% 0.93 zuwa 1.03) ga waɗannan gwaje-gwajen da suka dace da bazuwar cutar.6 Kiyasin ya kasance iri ɗaya ga sauran gwaje-gwajen, waɗanda wasu daga cikinsu ba a yi musu cikakken bayani ba ta yadda matsakaicin shekaru a cikin ƙungiyoyin biyu da aka kwatanta ba iri ɗaya ba ne, wanda hakan ya sa nazarin mace-mace gaba ɗaya ba shi da tabbas.
Ga gwaje-gwaje biyu daga cikin uku da aka yi bisa ga tsari, waɗanda suka fito daga Kanada da Birtaniya, akwai bayanan da suka biyo baya bayan shekaru 25 da 23, bi da bi.7,8 Rabon haɗarin mace-mace gabaɗaya shine 1.01 (tazara amincewa 95% 0.98 zuwa 1.03) ga dukkan gwaje-gwaje uku (duka tare da ingantaccen sakamako da kuma samfurin tasirin bazuwar, Cikakken Tsarin Nazarin Meta 3.0). A cikin tebur, shekarar tana nufin shekarar da gwajin ya fara:
Wannan sakamako ne mai ƙarfi sosai domin an samo shi ne daga jimillar mutuwar mutane 25,046. Saboda haka za mu iya cewa da babban kwarin gwiwa cewa gwajin mammography ba ya ceton rayuka.
Idan muka takaita nazarin zuwa gwaje-gwajen guda biyu tare da dogon bin diddigi, sakamakon iri ɗaya ne, rabon haɗari na 1.01 (0.99 zuwa 1.04).
Mutuwar Ciwon Nono Sakamako ne Mai Matuƙar Kuskure
Zai ba wa mutane da yawa mamaki su fahimci cewa ba za mu iya amincewa da abin da aka ruwaito a cikin gwaje-gwajen da aka yi bazuwar game da tasirin tantancewa kan mace-macen ciwon nono ba, amma wannan gaskiya ne a zahiri.6
An yi wa wasu tsirarun matan da suka mutu gwajin gawarwaki, kuma a wasu gwaje-gwaje da dama, ba a tantance musabbabin mutuwar ba a makance.6 Na rubuta cewa kimantawar musabbabin mutuwar ba ta da tushe sosai.6,9 Idan muka haɗa dukkan gwaje-gwaje a cikin binciken, za mu yi tsammanin ganin mafi girman raguwar mace-macen ciwon nono a cikin waɗannan gwaje-gwajen da suka fi tasiri wajen rage yawan kamuwa da cutar kansar da ke da alaƙa da ƙwayoyin cuta (cututtukan da suka kamu da cutar) a cikin rukunin da aka tantance.
Hakika haka lamarin yake, amma layin komawa baya bai dace ba. Yana annabta cewa tasirin tantance sifili (watau adadin cutar kansar da ke da alaƙa da ƙulli iri ɗaya ne a cikin ƙungiyoyin da aka tantance kamar yadda yake a cikin ƙungiyoyin da ke da alaƙa) yana haifar da raguwar mace-macen ciwon nono da kashi 16% (rage amincewa da kashi 95% zuwa kashi 23%).6,9 Wannan zai iya faruwa ne kawai idan akwai son zuciya, kuma ƙarin bincike ya nuna cewa tantance musabbabin mutuwar da kuma adadin cutar kansar da ke ci gaba duk sun nuna son zuciya don a tantance su.
Sharhin da aka yi a tsarin da ya haɗa da dukkan gwaje-gwajen, har ma da waɗanda ba a tsara su yadda ya kamata ba, sun ba da rahoton cewa gwajin mammography yana rage mace-macen ciwon nono da kashi 16-19%.6,10 Ganin cewa wannan kiyasin yana da girman iri ɗaya da na son zuciya a cikin nazarin koma-baya, wannan yana nuna cewa tantancewa ba ya rage mace-macen cutar kansar nono.
Wani dalili kuma da ya sa mace-macen ciwon nono ba shi da kyau shi ne cewa binciken da aka yi yana haifar da yawan gano cutar kansa, wanda shine gano cutar kansa da kuma abubuwan da suka riga suka fara kamuwa da cutar kansa (carcinoma in situ), wanda ba zai jawo hankalin mace a sauran rayuwarta ba, don haka da ba zai zama matsala ba tare da an yi mata gwaji ba. Tunda ba zai yiwu a bambance tsakanin cutar kansa marasa lahani da kuma cutar da ke da haɗari ba, duk ana yi musu magani, kuma maganin radiation da chemotherapy da aka bai wa mata masu lafiya suna ƙara yawan mace-macen.6
Idan muka yi la'akari da mace-macen da ake samu sakamakon ciwon zuciya da huhu sakamakon nau'in maganin radiation da aka yi amfani da shi lokacin da aka gudanar da gwaje-gwajen tantancewa kuma muka ɗauka cewa tantancewa yana rage mace-macen da ake samu sakamakon ciwon nono da kashi 20% kuma yana haifar da kashi 20% kawai na mace mai lafiya da aka gano ba ta da lafiya, to babu wata fa'ida ta mace-mace daga gwajin.11
A ƙarshe, abin lura ne cewa gwaje-gwajen da ba a yarda da su ba su ne waɗanda suka bayar da rahoton raguwar mace-macen da ke tattare da cutar kansar mama.6 Bambancin da aka samu a kiyasin tasirin da ke tsakanin gwaje-gwajen da aka yi bazuwar da kuma gwaje-gwajen da ba su da kyau sun kasance masu mahimmanci a kididdiga, bayan shekaru 7 da 14 na bin diddigin (P = 0.005 da P = 0.02, bi da bi).12
Jimillar Mutuwar Ciwon Daji
Tunda rashin rarraba musabbabin mutuwa galibi yana da alaƙa da mutuwar wasu cututtukan daji,6 Jimillar mace-macen ciwon daji sakamako ne da bai kai na son zuciya ba kamar mace-macen ciwon nono.
Wasu masu gwaji ba su bayar da rahoton jimillar mace-macen da cutar kansa ta yi ba, amma muna da bayanai daga gwaje-gwaje uku da aka yi bisa ga tsari.6,8 Babu wani tasiri na gwajin cutar kan jimillar mace-macen da ake samu a kansa, ciki har da ciwon nono, rabon haɗarin 1.00, tazara amincewa da kashi 95% 0.96 zuwa 1.04. Akwai ƙungiyoyin shekaru daban-daban guda biyu a gwajin Kanada, shekaru 40-49 (a) da shekaru 50-59 (b):
Tunda jimillar mace-macen ciwon daji ba ta da bambanci da mace-macen ciwon nono, yana da kyau a ga yadda mace-macen ciwon daji (gami da mace-macen ciwon nono) zai kasance idan aka samu raguwar mace-macen ciwon nono da kashi 29% bayan shekaru 7 a cikin gwaje-gwajen da ba a yi musu kyau ba6 gaskiya ne.
Da ya kasance rabon haɗari na 0.95, wanda ya yi ƙasa sosai (P = 0.02)6 fiye da abin da aka gano a zahiri. Wannan ya ƙara tabbatar da cewa tantance musabbabin mutuwar an nuna son kai ne a tantance shi.
Ba a Gano Ciwon Nono da wuri ba amma a makare sosai
Idan muka ɗauka cewa sau biyu da aka lura a cikin nazarin ciwon daji na tsawon lokaci suna dawwama tun daga lokacin da aka fara shi har sai an gano ciwon, matsakaicin mace tana ɗauke da ciwon daji tsawon shekaru 21 kafin ya kai girman 10 mm kuma ya zama mai iya ganewa akan mammogram.13
Ganin wannan dogon lokaci, yana da kuskure a kira shi "ganowa da wuri" kuma saboda tasirin tantancewa ba shi da mahimmanci, wato don ci gaba da gano cutar da ƙasa da shekara guda.13
Duk da haka dukkan hukumomi suna maimaita wannan mantra. Ganin cewa ba zai yiwu ba cewa duk wanda ke aiki da cutar kansa bai san tushen ilimin halittar ciwon daji ba, za mu iya yanke hukuncin cewa ana ba da bayanai marasa tushe ga jama'a a duk faɗin duniya. Wannan zamba ne saboda an yi shi da gangan kuma saboda mata suna tunanin "ganowa da wuri" zai ceci rayuwarsu.
Na taɓa tambayar wani shahararren masanin ilmin halittar ciwon daji, Keld Danø, a lokacin hutun kofi a wani taro na ƙasa da ƙasa, ko ya yarda da ni cewa ba zai yiwu a rage mace-macen ciwon nono da kashi 30% ba tare da an tantance su, bisa ga iliminmu game da ilimin halittar ciwon daji.14 Ya yarda. Lokacin da na tambaye shi dalilin da yasa mutane irinsa ba su shiga muhawarar kimiyya ba, bai amsa ba kuma ba shi da wahala a yi tunanin dalili. Ba hikima ba ne a nuna cewa abokan aikinka sun yi kuskure idan kana karɓar manyan kuɗaɗe daga wata ƙungiyar agaji ta ciwon daji wadda ke nuna cewa ana tantancewa.
Mata suna shan wahala yayin da kowa ke samun wadata.
Ba a gano canje-canjen ƙwayoyin halitta na farko, wato cutar kansa a wuri, sai dai idan an yi wa matan gwajin mammogram. A cikin nazarinmu na tsari kan ƙasashe masu shirye-shiryen tantancewa, mun gano cewa an gano fiye da kashi 35% na cutar kansar da ta mamaye su da kuma kashi 52% lokacin da muka haɗa da cutar kansa a wuri.15
Duk da cewa ƙasa da rabin waɗanda suka kamu da cutar kansar a wuri ɗaya suna komawa ga cutar kansa mai yaduwa,16,17 Duk da haka ana yi wa mata magani akai-akai ta hanyar tiyata, magunguna, da kuma maganin radiation.
Babban abin mamaki shi ne cewa tiyatar galibi ana yin ta ne da tiyatar mastectomy saboda canje-canjen ƙwayoyin halitta na iya yaɗuwa a cikin nono, wani lokacin ma a cikin nonon biyu. A New South Wales, kashi ɗaya bisa uku na mata masu cutar kansa a wurin an yi musu tiyatar mastectomy.18 kuma a Burtaniya, cutar kansa a wuri ana yawan yi mata magani ta hanyar tiyatar cire ciki fiye da cutar kansa mai yaduwa,19 kuma adadin matan da aka yi wa tiyatar cire mastectomy ya kusan ninka sau biyu daga 1998 zuwa 2008.20
Wannan ya kawo mu ga babban ƙarya ta uku a cikin farfagandar da ake yi game da tantancewar mammography.
Dubawa Ba Ya Ragewa Amma Yana Ƙara Tsarin Gyaran Jiki
Saboda yawan gano cutar kansa mai yaduwa da kuma cutar kansar da ke yawo a wuri, kuma saboda tantancewa yana ƙara gano cutar kansa mai yawo kaɗan,13 babu makawa cewa gwajin yana ƙara yawan ƙwayoyin cuta.
A cikin gwaje-gwajen da aka gudanar bazuwar na tantancewa, mun sami ƙarin kashi 31% na ƙwayoyin cuta a cikin ƙungiyoyin da aka tantance fiye da ƙungiyoyin da ke kula da su.6
Denmark ƙasa ce ta musamman da za a yi nazarin wannan a aikace domin mun shafe shekaru 17 (1991-2007) inda kusan kashi 20% na mata masu cancanta ne kawai aka gayyata don yin gwajin saboda wasu gundumomi ba su da gwajin.21 Idan aka fara tantancewa, za a yi ƙarin ganewar cutar kansar mama fiye da yadda aka saba kuma za a sami ƙarin gwaje-gwajen tiyata. Duk da haka, kamar yadda ake gani a jadawalin, ba a rama babban ƙaruwar tiyatar tiyata ta hanyar raguwar tiyatar tiyata daga baya ba inda aka sami irin wannan raguwar tiyatar tiyata a wuraren da ba a yi musu gwaji ba kamar yadda aka yi a wuraren da aka yi musu gwaji:22
Bugu da ƙari, kamar yadda jadawalin da ke gaba ya nuna, babu raguwar diyya a cikin ƙungiyoyin tsufa:22
Duk da haka ana gaya wa mata cewa gwajin yana haifar da tiyatar da ba ta da illa, tare da ƙarancin tiyatar mastectomy. Wannan ba gaskiya ba ne a cikin bayanai.
Dabara da aka fi amfani da ita don ɓata wa mata rai game da wannan batu ita ce a bayar da rahoton kaso maimakon lambobi.3 Ka yi tunanin gari mai wani matakin laifuka. Ka raba laifukan zuwa manyan laifuka da marasa tsanani. A tsawon lokaci, yawan laifuka masu tsanani yana ƙaruwa da kashi 20%, yayin da adadin laifuka marasa tsanani ke ƙaruwa da kashi 40%. Wannan ci gaba ne ga mafi muni. Amma kodayake Kara mutane suna fuskantar manyan laifuka da kuma Kara Mutane suna fuskantar manyan laifuka, wani mai wayo zai ce haka, kamar yadda ake yi a yanzu in mun gwada ƙarancin shari'o'in manyan laifuka, lamarin ya inganta.
Abin takaici ne cewa mutanen da suka fi sani - masu binciken cutar kansa, kungiyoyin agaji na cutar kansa, hukumomin lafiya na ƙasa, da sauransu - sun yi wa jama'a ƙarya ta wannan hanyar3 kuma har yanzu suna yi, sabanin hankali da shaidar kimiyya.
Ƙarshen Rashin Gaskiya
Wurin tantance mammography ya cika da rashin gaskiya. Har na buƙaci in rubuta cikakken littafi wanda ke bayani dalla-dalla kan duk hanyoyin da masu bincike da sauransu suka yi amfani da su wajen nuna kamar Sarki yana sanye da kaya alhali kuwa a zahiri yana tsirara.3
Yaudara ta gaba ɗaya ce domin koyaushe tana ci gaba bayan na nuna wa editan a cikin wasiƙun da na rubuta wa editan abin da masu binciken suka yi ba daidai ba, kuma suka mayar da martani a kai.3,14 Saboda haka ba za su iya cewa ba su san cewa sun ci gaba da sarrafa bayanai da kuma yaudarar jama'a ba.
Uku daga cikin marubuta mafi rashin gaskiya da kuma yawan rubuce-rubuce sune László Tabár, Stephen Duffy, da Robert Smith. Tsawon shekaru da yawa, sun kai hari ga bincike mai zurfi da na yi kan tantance mammography amma ba tare da hujjoji masu gamsarwa ba.3,14 – suna da ƙwarewa a muhawarar ad hominem.
László Tabár shi ne babban mai bincike na binciken da aka gudanar a gundumar Sweden ta biyu, wani gwaji da aka yi a farkon lokacin da aka bayar da rahoton babban tasirin tantancewa, wanda ya rage mace-macen da ake samu a kansar mama da kashi 31%.23 Wannan gwajin ya taimaka wajen gabatar da tantancewa. Duk da haka, akwai manyan bambance-bambance a adadi, kuma wasu daga cikin binciken ba su da tabbas kuma ba su dace da halayen ƙari da aka ruwaito ba, har ya yi kama da rashin da'a a kimiyya.3,6,24-27 Tabár ya sami arziki a gwajin mammography kuma yana da dabi'ar yin barazana ga shari'a duk lokacin da wani ya kusanci sirrinsa sosai.3,14,23
Ba za a yi tunanin cewa Stephen Duffy farfesa ne a fannin kididdiga ba domin ya karkatar da bayanan fiye da abin da ya dace ta hanyoyi da dama na kirkire-kirkire da rashin tabbas.3,6,14 Robert Smith ya taɓa zama Daraktan Binciken Ciwon daji a Ƙungiyar Ciwon daji ta Amurka.
Wannan triumvirate ya bayar da rahoton raguwar mace-macen da ake samu a kansar mama da kashi 63% a wani bincike da aka gudanar.28 Na nuna wasu matsaloli da ke tattare da bincikensu,29 amma a cikin jawabinsu,30 su
idan aka kwatanta matan da suka halarci tantancewar da matan da ba su halarta ba, kodayake a bayyane yake daga
takardar da suka rubuta cewa sun san cewa irin waɗannan kwatancen suna ɓatarwa sosai.
Waɗannan marubutan sun yi iƙirarin, bisa ga bayanan binciken da Gundumomin Biyu suka yi, cewa sun sami "raguwar mace-mace mai mahimmanci da kashi 13% a kididdiga tare da gayyatar yin gwaji."31,32 Wannan ba daidai ba ne kuma ba zai yiwu ba kwata-kwata. Ko da yake gwajin ya yi tasiri 100% kuma ya hana dukkan mace-mace daga cutar kansar mama, ba zai iya rage yawan mace-macen da kashi 13% ba.
Sun kuma yi hasashen cewa idan aka daɗe ana gudanar da wani shirin tantancewa, mutum zai iya tsammanin raguwar mace-mace da kashi 3-4% cikin ɗari.31 Wannan kuma ba zai yiwu ba sai dai idan gwajin ya hana dukkan mace-macen da suka shafi kansar mama. Haɗarin mutuwa daga cutar kansar mama a tsawon rayuwa shine kashi 2.5-3%,33 kuma kashi 3-4% ne a ƙasashe da yawa kafin a gabatar da tantancewa.
Na yi bayani a cikin littafina cewa idan suka ci gaba da binciken wasu cututtuka, za su iya samun hanyar samun rai madawwami.3 Na kuma lura cewa matsalar ƙarya ita ce
ko ba da daɗewa ba mutane kan saba wa junansu, wanda suka yi dangane da wani bincike da suka buga a ciki The Lancet.3
Wata hanyar da aka saba amfani da ita wajen yaudarar masu karatu ita ce a ce gano cutar kansar mama da wuri "yana rage mace-mace"34 ba tare da bayyana irin mace-macen da wannan ke haifarwa ba, wanda hakan ke sa mai karatu ya yi imani da cewa tantancewa tana ceton rayuka.
Kuskuren da aka fi sani a cikin littattafan tantancewa shine mutane suna fassara tasirin da aka rubuta akan mace-mace daga cutar kansa zuwa tasirin da ke kan mace-macen da ke haifar da dukkan dalilai. Muna ganin da'awar a ko'ina cewa gwaje-gwajen tantance cutar kansa na yau da kullun suna ceton rayuka amma wani bita na tsari na gwaje-gwajen da aka yi bazuwar ya gano cewa gwajin tantancewa kawai wanda ke da babban riba a rayuwa shine sigmoidoscopy. Ya tsawaita rayuwa da kwanaki 110 a matsakaici, kuma yayin da tazara ta amincewa da kashi 95% ya tafi daga kwanaki 0 zuwa 274, wannan sakamakon yana gab da zama ba shi da mahimmanci a kididdiga.35
Wata dabara da aka saba amfani da ita ita ce amfani da maganganun zato idan muna da wani ilimi. Misali, marubuta na iya rubutawa - har ma a cikin mujallun likitancinmu mafi daraja - cewa gano cutar kansa fiye da kima "na iya" faruwa ga masu kamuwa da cutar kuma yana iya "haifar da lahani" ta hanyar sanya wa marasa lafiya lakabi da kuma kula da su ba tare da an tantance su ba, waɗanda ba a taɓa gano su ba.34 Waɗannan ba zato ba tsammani ba ne; su ne sakamakon da ba makawa na tantancewa.
Tun daga shekarar 2000, na buga labarai da dama na kimiyya, wasiƙu zuwa ga edita, labaran jarida, da littattafai biyu game da gwajin mammography waɗanda ba sa barin shakku cewa wannan shiga tsakani yana da matuƙar illa.37
Ko da yake na san cewa babu wanda za a taɓa hukunta, ina ɗaukarsa a matsayin laifi da aka yaudari mata ta hanyar da ta dace su yarda cewa tantancewa abu ne mai kyau a gare su. Bisa ga ƙa'idodin amincewa da bayanai, dole ne a sanar da mutane game da fa'idodi da illolin da ke tattare da shiga tsakani da ake bayarwa, amma an yi watsi da wannan ƙa'idar ɗabi'a sosai. Har zuwa wani mataki a ƙasashe da yawa, mata suna samun "gayyata" zuwa gwajin mammography tare da lokacin da aka riga aka keɓe don yin gwajin mammography wanda ba su taɓa tambaya ba.1 Wannan yana sa su yi imani cewa yana da matuƙar muhimmanci su zo su kuma matsa musu lamba su soke alƙawarin idan ba sa son a yi musu gwajin mammogram. Idan suka ƙi, galibi ana yi musu wasiƙun bin diddigin su ta hanyar tilasta musu su yi hakan.
Ga wasu misalan ayyukan da ba su dace ba sosai:1
"Mun yi tanadin lokaci... Idan lokacin bai yi kyau ba, muna roƙon ku da ku tuntuɓi cibiyar tantance mammography da wuri-wuri;" "Ina damuwa cewa har yanzu ba ku amsa gayyatarmu ta kwanan nan don gwajin mammogram ba;" "Idan kuna son guje wa shiga, muna roƙon ku da ku cike fom. Kuna samun wannan fom ta hanyar kiran cibiyar tantance nono;" "A cikin shekaru biyu da suka gabata, mata sama da 340,000 na Queensland sun amfana da shiga cikin Shirin Queensland na Screen BreastScreen," "Kuna iya ɗaukar mataki mai kyau don rage haɗarin ku, da kuma taimaka mana mu cimma burinmu, ta hanyar yanke shawarar shiga."
Abin da ya fi muhimmanci shi ne a tabbatar da cewa an samu ci gaba sosai, wato "burinmu," ba wai matan su fahimci abin da ake yi musu ba.
Ina ba mata shawara a duk ƙasashe da kada su je gwajin mammography kuma kada su yi komai idan an "gayyace su," wanda matata ta yi. Ba ta da wani wajibi na kin amincewa da "gayyata" tare da lokacin da aka riga aka keɓe mata, kuma wasiƙar ta sa ta fusata.
Tantancewa yana da illa ta hanyoyi da yawa fiye da waɗanda na ambata a nan, misali tsakanin kwata ɗaya zuwa rabi, ya danganta da ƙasar da ake ciki, na duk mata da ke halartar tantancewa akai-akai za su fuskanci aƙalla sakamako ɗaya na ƙarya, wanda zai iya zama abin damuwa na tsawon shekaru da yawa.36 Saboda haka yana haifar da wata babbar illa.6,14
Kamar yadda na yi bayani a wani wuri,38 Cochrane Collaboration ta ƙi ba mu damar sabunta bitar Cochrane ɗinmu kan gwajin mammography a bara, duk da cewa na sabunta shi sau uku a baya kuma sabuntawar kawai game da ƙara ƙarin mace-mace ne ga gwaje-gwajen biyu.
Abin mamaki, "Editan Shiga Ba Tare Da Shi Ba" ya lura cewa bitarmu na iya haifar da mummunar mummunar mummunar mummunar fahimta kuma an zarge mu da samun ra'ayoyi da aka riga aka tsara game da rashin fa'idar tantancewa "maimakon la'akari da cewa yana da fa'ida da ba a gano ba." An kuma hana mu amfani da kalmar overdiagnosis duk da cewa wannan abu ne na yau da kullun kuma yana bayyana a cikin wasu bita na Cochrane game da gwajin cutar kansa, gami da namu.6,12
Lokacin da na fara buga bitar Cochrane, a shekara ta 2001, akwai babban abin kunya.39 domin Cochrane ya hana mu wallafa bayananmu kan illolin da suka fi yawa na tantancewa, gano cutar fiye da kima, da kuma yin magani fiye da kima.3 Wannan ya kamata ya sa shugabannin Cochrane su kula da sabbin bayanai da muka samu ta hanyar da ta dace, amma sun fi son goyon bayan akidar da ake amfani da ita wajen tantancewa maimakon gaya wa mata gaskiya.
Tambaya ɗaya ce kawai ta rage: Wace ƙasa ce za ta fara nuna ɗan hankali da girmamawa ga kimiyya sannan ta daina nuna alamun cutar?
References
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2 Gøtzsche P, Hartling OJ, Nielsen M, Brodersen J, Jørgensen KJ. Gwajin nono: gaskiyar magana - ko wataƙila a'a. BMJ 2009; 338: 446-8.
3 Gøtzsche PC. Binciken Mammography: gaskiya, ƙarya da jayayya. London: Radcliffe Publishing; 2012.
4 Gwajin Mammography Yana Ceton RayukaKwalejin Nazarin Radiology ta Amurka 2026; 27 ga Fabrairu.
5 Shawarwari na Ƙungiyar Ciwon daji ta Amirka don Farko Ganewar Ciwon Kankara. 2026; 27 ga Fabrairu.
6 Gøtzsche PC, Jørgensen KJ. Binciken ciwon nono tare da mammography. Cochrane Database Sys Rev 2013;6:CD001877.
7 Miller AB, Wall C, Baines CJ, da sauransu. Binciken shekaru ashirin da biyar don kamuwa da cutar kansar nono da mace-mace na Nazarin Gwajin Nono na Ƙasa na Kanada: gwajin gwaji bazuwar. BMJ 2014;348:g366.
8 Duffy SW, Vulkan D, Cuckle H, da sauransu. Tasirin gwajin mammographic daga shekaru 40 akan mace-macen ciwon nono (Gwajin shekarun Burtaniya): sakamakon ƙarshe na gwajin da aka tsara bazuwar, wanda aka sarrafa. Lancet Oncol 2020; 21: 1165-72.
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13 Gøtzsche PC, Jørgensen KJ, Zahl PH, Maehlen J. Dalilin da yasa gwajin mammography bai cika tsammanin gwaje-gwajen da aka yi bazuwar baMaganin Sanadin Ciwon Daji 2012;23:15-21.
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18 Kricker A, Smoothy V, Armstrong B. Ciwon daji na Ductal a wurin da ake kula da shi a cikin mata a NSW a tsakanin 1995 zuwa 1997. Cibiyar Ciwon Daji ta Nono da Kwai ta Ƙasa 2000; 15 ga Afrilu.
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32 Duffy SW, Tabár L, Vitak B, Yen MF, Warwick J, Smith RA, Chen HH. Gwajin gwajin mammographic na gundumar Sweden guda biyu: bazuwar rukuni da kimantawa ta ƙarshe. Ann Oncol 2003; 14: 1196-8.
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38 Gøtzsche PC. Cochrane a kan aikin kashe kansa. Jaridar Brownstone 2025; 20 ga Yuni.
39 Horton R. Duban mammography - sake duba wani bayani. Lancet 2001; 358: 1284-5.
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Dokta Peter Gøtzsche shi ne ya kafa Cochrane Haɗin kai, wanda da zarar an yi la'akari da babbar ƙungiyar bincike ta likita mai zaman kanta ta duniya. A cikin 2010 Gøtzsche an nada shi Farfesa na Tsarin Bincike na Clinical da Bincike a Jami'ar Copenhagen. Gøtzsche ya buga fiye da 100 takardu a cikin "manyan biyar" mujallolin likita (JAMA, Lancet, New England Journal of Medicine, British Medical Journal, da Annals of Internal Medicine). Gøtzsche ya kuma rubuta litattafai kan al'amuran kiwon lafiya da suka hada da Magungunan Mutuwa da Laifukan Tsara.
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