Jayayya don kare lafiyar cutar kwakwalwa
Idan ka duba labarai a cikin 'yan shekarun da suka wuce, tabbas ka ji wasu muhawarar game da cutar kanjamau. Tattaunawa da farko shine ko Medicare ya kamata a rufe cutar CT ta Ebola ko kuma a'a a cikin wadanda suka hadu da ka'idodi. A cikin Fabrairu na 2015, an yanke shawarar ne a matsayin Madina Medicare a yanzu ya rufe wannan gwaji. Dalilin gardama shi ne binciken - a cikin babban binciken likita da ake kira Cutar Tuntun Cutar Canjin Cutar (LDCT) - zai iya rage kwayar cutar kanjamau ta hanyar kashi 20, ko 18,000 na Amurka a kowace shekara.
Zai yi kyau duka, duk da haka bincike na shekara ta 2016 ya gano cewa ƙasa da rabi na likitocin iyali sun yarda cewa bincikar cutar kanjamau na da kyau kuma mutane da dama basu san wasu shawarwari ba. Bugu da ƙari, yawancin waɗannan likitoci suna ci gaba da yin adadin rayukan hasken rana kamar gwajin gwajin cutar kanjamau. Wannan, ta biyun, ya haifar da tambaya guda ɗaya:
"Me ya sa likita ba zai ba da izinin gwajin da zai iya ceton rayuwata ba?"
Mene ne muhawarar da kuma kan cutar kanjamau, da abin da kungiyoyi ke goyan bayan waɗannan muhawarar? Bari mu dubi wadannan wurare kuma mu kwatanta cutar kanjamau da ke nunawa ga sauran gwajin gwaje-gwaje a halin yanzu ana samuwa.
* Medicare yana rufe cutar kanjamau wanda ke nunawa wadanda ke da shekaru 55 zuwa 77, wanda ke ci gaba da shan taba ko kuma ya bar shi a cikin shekaru 15 da suka gabata, kuma ya taba shan taba don akalla shekaru 30. Nunawa yana buƙatar sa hannun likitan likitan (ko wanda ba likita wanda ya cancanta) kuma yana buƙatar mutumin da za a kula da shi ya sadu da likita don shawara don shiga cikin yanke shawara na yanke shawara kafin a rubuta umarnin.
Wanene Ya Amfana daga Gyaran Ciwon Cutar Canjin Daji?
Bayan shekaru masu yawa ba tare da wani gwaji na gwajin gwajin cutar kanjamau ba, jarrabawar Kwalejin Kwayar Ciwon Kankara ta kasa (NLST) ta gano cewa samfurin CT (LDCT) ƙananan zai iya ceton rayuka tsakanin mutanen da suka cika wasu ka'idodi. A cikin mutane da suka hadu da waɗannan ka'idoji, yin nazarin LDCT a kowace shekara zai iya rage yawan cutar kanjamau ta hanyar kashi 20 cikin dari - yawan da ya fassara zuwa dubban dubban 'yan Amurkan a kowace shekara.
Bisa ga binciken da aka samu na Amurka (USPSTF) ya bada shawarar yin nuni don:
- Manya tsakanin shekarun 55 da 80 wadanda suke da tarihin shan taba na shekaru 30, da kuma
- Ci gaba da shan taba ko barin shan taba a cikin shekaru 15 da suka gabata
Binciken zai iya zama dacewa ga wasu mutane, irin su waɗanda aka ba da shaida ga asbestos, tarihin tarin fuka, radon nunawa , sassan mutunyar BRCA2 , da sauran yanayi.
Dalilin da za a yi murna game da LDCT Lung Cancer Screening
- A halin yanzu, akalla kashi 40 cikin dari na mutanen da ke fama da ciwon daji na huhu suna bincikar cutar lokacin da cutar ta riga ta cigaba da aiwatar da cutar kanjamau .
- Yau shekaru 5 na yawan lafiyar cutar kanjamau a cikin kwayar cutar kanjamau kusan kashi 17 ne kawai.
- Lokacin da aka samu ciwon huhu a cikin matakai na farko, rayuwa ta fi girma.
- Sauran nau'i na nunawa wanda aka yi la'akari da su har zuwa zamani, irin su ragowar fuka da kuma cytology , ba a gano su don rage mutuwar ba.
- Labaran cutar huhu shine babban dalilin ciwon daji na maza da mata a Amurka. Yana kashe kusa da sau biyu mata kamar ciwon nono.
- Kwanan nan ma an gano cewa wasu masu shan taba da ke da LDCT suna iya barin su fiye da idan ba a yi gwajin ba. Kodayake yana da wuri da za a ce, sanin wasu cututtuka da shan taba ya nuna cewa, a matsayin ƙarin haɓaka, cutar kanji na iya rage cututtukan zuciya, COPD, da sauransu.
- Daga cikin marasa lafiya na Medicare, an yi zaton cewa jarrabawar LDCT a kowace shekara zai iya zama fiye da kashi biyu cikin kashi na bincikar cutar kanjamau na farko (A matsayin gwadawa mai saurin, tsawon rayuwar shekaru 5 na ciwon ƙwayar cutar kanjamau ba kashi 60 zuwa 80 ba. Don mataki 2 shi ne 40 zuwa 50 bisa dari. Don mataki na 4 shi ne ƙasa da kashi 5). An yi tunanin cewa wannan zangon zai gano 54,000 ƙarin cutar wutsiya a kowace shekara (32,000 a farkon mataki.)
- Idan an aiwatar da jagorori masu nuni a nan da nan, kuma idan duk wanda ya sadu da ka'idoji don nunawa zai shawo kansa, za'a iya ceton mutane 18,000 a kowace shekara.
Matsalolin Gudanar da Aiki tare da Juyawa
Duk wani gwaji na gwaji ya zo tare da wasu matsalolin. Yawancinku na iya sanin wani wanda ya tsorata akan mammogram - don jin cewa kawai tsoro ne. Wasu daga cikin matsalolin da ake nunawa da cutar kanjamau na iya hada da:
- Sakamakon ƙarya
- Sashin karya
- Bayanin ƙwarewa
- Rawanin zafi
Yaya An Yi Kwankwar Cutar Canjin Ciwon Cutar?
{Ungiyar Ta'addanci ta {asar Amirka (USPSTF) ta ba da shawarar cutar kanjamau ta tantancewa a matsayin wani mataki na Jami'ar B. A karkashin Dokar Kulawa da Kulawa (ACA) masu insurers masu zaman kansu suna buƙata don rufe tsarin bincike tare da Grade B ko mafi girma (duba ƙasa). Wannan shi ne tasirin Janairu 2015. Ma'aikatar Makamashi, Ma'aikatar Harkokin Kasuwanci (Murtalawa) ta rufe shi ne (godiya, kamar yadda tsofaffin sojan na fama da cutar ciwon huhu,) da sauransu.
Menene Game da Medicare?
A watan Afrilu, MEDCAC ya ba da shawara kan cutar kanjamau na LDCT don neman amfana - a cikin wasu kalmomi, ba a rufe shi a matsayin "lafiyar lafiyar lafiyar" ba tare da kudin ba. Dalilin shi ne cewa ba su da tabbacin cewa amfanin zai rage yawan halayen a cikin wannan yawan. Ya bambanta da masu insurers masu zaman kansu, Amfanin Medicare ba a rufe su a ƙarƙashin Dokar Kulawa mai Kulawa . Za a yi yanke shawara karshe ba sai Fabrairu 2015.
Wane ne yake goyon baya ga ƙwayar cutar ciwon huhu?
Binciken gaggawa na yanar gizo ya sami kungiyoyi masu zuwa don tallafawa ciwon daji na kwakwalwa (suna da shawarar da Medicare ya yanke :)
- Ƙungiyar lafiya ta Amirka (AMA)
- Cibiyar Harkokin Lafiya ta {asar Amirka (ACR)
- Cibiyar Kwayar Ciwon Kankara ta Lung (LCA) - LCA ta mika takardar neman sammacin Neman Shafin Kasuwanci don bincikar cutar kanjamau.
- Ƙungiyar Ayyukan Tsaro ta Amurka (USPSTF)
- Ƙungiyar Amurkan Cibiyar Harkokin Kwayoyi ta Amirka
- Ƙungiyar Ciwon Kankara ta Amirka (ACS)
- Ƙungiyar 'yan likitocin Thoracic (STS)
- Yawancin Sanata da wakilan Majalisar
Wanda ba ya goyan bayan maganin kwari da cutar huhu
Tun daga watan Oktobar 2016, Cibiyar Harkokin Kasuwancin Amirka ta bayyana cewa akwai hujjoji marasa rinjaye don yin mulkin ga ko kuma a kan nunawa.
Arguments / Counterarguments a cikin goyan bayan maganin cutar kwantar da hankalin huhu - Kwatanta Al'ummai zuwa Apples
- Magungunan shaidar tabbatarwa . An nuna magungunan ciwon huhu na huhu a cikin maganin shaida don ceton rayuka. Binciken da aka yi a kwanan nan ya ce bazawar cutar kanji ba. Wani binciken da aka yi a kwanan baya ya gano cewa mammogram na nunawa yana da tasiri sosai akan mace-mace a cikin mata masu shekaru 50 zuwa 69, kuma basu da mahimmanci ga mata a cikin shekarun da suka wuce 70. Ana saran ganin yadda ake fama da cutar kanjamau ya rage yawan cutar kanjamau a cikin wadanda ke cikin Medicare shekaru kungiyar. Duk da haka, Medicare tana biya mammogram amma ba ya biya wajan cutar kanjamau.
- Abubuwan Kuɗi - Kudin da za a iya yaduwar cutar kanjamau ga masu karɓa na Medicare yana da mahimmanci, amma ana fassara zuwa kimanin $ 3 a kowace wata ta mai amfani. Kudin da ake nunawa na likitancin nono don Medicare masu amfana ya kai kimanin dala 2.50 a wata. Ka lura da cewa $ 3 a kowane wata don ganowa kan cutar kanjamau ya hada da bin biyo baya (alal misali don neman alamun ƙarya,) amma $ 2.50 a kowane wata don nunawa kan cutar ta nono ba ya haɗa da gwaje-gwaje da hanyoyin da ake bi. Idan aka dubi wasu lambobi a cikin wasu nazarin, an yi la'akari da cewa za a kashe dala biliyan 2 na Medicare a shekara don bayar da cutar kanjamau ta cutar huhu tare da dala miliyan 1.08 zuwa 1.36 ga mammogram. Ka yi la'akari da cewa dukkanin mata da namiji za su amfana daga yaduwar cutar huhu, amma mafi yawan lokutan mata suna samun mammogram. Ba zan shiga farashin magani ba. Binciken, ba shakka, zai kara yawan ciwon daji na ciwon daji na jikin mahaifa saboda karuwa a cikin gwajin farko, kuma ba shakka, yana da tsada don biyan kuɗin rage yawan ciwon daji da bin goyan bayan mutuwar. Za mu iya auna farashin wannan magani na kututtukan dajin daji na farko da halin kaka na kula da cutar kanjamau da kuma damuwa na ƙarshen rayuwa, amma ina so in je can. Daga gadoje, babu kwatanta. Haka ne, na ga ciwo yayin da mutane ke dawowa daga tiyata, amma yana iya kwatanta da ciwon rai na ƙarshe tare da ƙananan ƙaddarar da ƙananan matakan.
- Tambayar da za ta mayar da hankali ga katsewar shan taba . Haka ne, wannan yana da mahimmanci, duk da haka, ba zai taimaka wa wadanda suke da 'yan takara don nunawa wadanda suka bar shekaru 15 da suka gabata ba. Yana da ban sha'awa a sake lura, cewa kamar yadda aka gani a sama, nunawa yana inganta ƙimar shan taba a wasu mutane (kuma yafi dacewa da lambobi fiye da shirye-shiryen da kuma taimakon muna da samuwa.) Amma mahimmanci - idan za mu bi da waɗanda ke cikin haɗari na ciwon daji na kwakwalwa daidai ga waɗanda ke hadarin wasu nau'in ciwon daji muna bukatar muyi daya daga abubuwa 2. Ko dai Medicare ya kamata a bincikar cutar LDCT don cutar ciwon huhu, ko kuma amfani da irin wannan nuna bambanci ga mutanen da ke fuskantar hadarin daji na nuna ciwon daji. Alal misali, idan Medicare ya fi so ya biya bashin shan taba ba tare da nazarin cutar kanjamau ba, to yana cewa ya kamata ya biya don ilmantar da mata don yaye 'ya'yansu, maimakon biya wa mammogram. Haka ma Medicare ya kamata ya mayar da hankali ga karfafa motsa jiki maimakon rufe mahaukaci kamar yadda ciwon daji ke hade da salon zama a cikin wasu lokuta. (Haka ne, ina da kyau, amma yana da mahimmanci don ci gaba da kwatanta apples zuwa apples, kuma wannan yanke shawara ya damun ni cewa cutar kutsawa na huhu zai iya taka muhimmiyar rawa a cikin yanke shawara.) A cikin tarihin tarihin duniya a wannan shekara daya daga cikin An tambayi yara wannan tambaya. "Mene ne mafi mũnin zama bawan?" Amsar ita ce a cikin Caribbean, domin a maimakon ciyar da kulawa da bawa, yana da rahusa don "amfani da shi" kuma saya wani kuma saboda wannan dalili, wannan tunanin ya ci gaba da tunawa yayin da na keta wannan gardama.
- Sakamakon ƙarya - Haka ne, bincikar cutar kanjamau ya haifar da halayen ƙarya. Saboda haka yana nuna aljan nono. Sakamakon halayen ƙarya an lura da su har zuwa kashi 25 cikin dari na mutanen da ke fama da cutar kanjamau, yana buƙatar ƙarin kararraki da kuma wasu lokuta mawuyaci. Daga marasa lafiya da suka biyo bayan mammogram shekara 10 na shekaru 10, halayen saɓin ƙarya sun kasance 50 zuwa 60%. Bugu da ƙari, kimanin 90,000 marasa lafiya sun biyo bayan shekaru 25 tare da tantance mammogram, 22% sun kamu da su ko kuma sun bi da su ba tare da maganin ba. Duk da haka mammography wani amfani ne wanda aka kare a karkashin Madica, amma cutar kankara ba kamar yadda aka yi tunanin cewa cutar (lamarin ƙarya, overdiagnosis) na iya zama mafi alhẽri (kashi 20% na rayuwan rayuwa). Shin, MEDCAC yana tsammanin zaiyi jayayya da hatimi ruwan hoda idan sun bi da apples a matsayin apples kuma sun ki su rufe mammogram saboda hadarin halayen ƙarya?
- Rawanin radiation - Mun koyi cewa daukan hoto zuwa radiation na kiwon lafiya ba tare da hadari ba.
- USPSTF Grade B - {ungiyar Ma'aikatar Tsaro ta {asar Amirka ta yi amfani da "matakan" wanda ya dubi amfana daga samar da sabis ga marasa lafiya. Grade B yana nufin cewa USPSTF ya bada shawarar sabis saboda akwai babban tabbacin cewa amfanin net yana da matsakaici ko kuma cewa akwai tsaka-tsakaccen tabbacin cewa amfanin net yana da matsakaici don ƙwarewa. Don dubawa kan cutar kanjamau, LDCT yana nunawa a matsayin Matsayi na B ga marasa lafiya kamar yadda aka tattauna a sama. Ana ganin yadda ake nuna ciwon daji ta hanyar mammography a matsayin Grade B ga mata kowane shekara 1 zuwa 2 bayan shekaru 40.
- Tambaya game da abin da muka koya daga tantancewar cutar kanjamau - Wata hujja a kan yanar gizo shine cewa ya kamata mu yi hankali game da cutar kanjamau don ganowa da kuma yin amfani da misalin cutar kanjamau ta hanyar nunawa. Shekaru da dama, an ƙarfafa maza don samun zane-zane na cutar ta prostate, kuma gwaje-gwacen PSA sun zama kalmar gida. Binciken Cochrane na binciken da yawa na yanzu ya gano cewa cutar shan ciwon ciwon gurguwar ƙwayar cutar ba ta rage yawan ciwon daji na ƙwayar prostate-musamman mace-mace (mutuwar) ko mace-mace baki daya. Bugu da kari, cutar (daga overdiagnosis da overtreatment) an kiyasta azaman na kowa da matsakaici. Halin shekaru 5 na rayuwa na ciwon ta prostate shine 99%. Wannan yana kwatanta apples zuwa apples?
- Marasa lafiya suna da kyau . Da yake cewa ba su da tabbacin cewa amfanin da ba zai yiwu ba a cikin wannan yawan jama'a, Medicare yana musun marasa lafiya na da damar yin hukunci da kansu - yanke shawara da aka yi tare da taimakon likita wanda zai iya taimakawa marasa lafiya da sha'awar shiga cikin nunawa yi la'akari da hadarin da kuma amfani ga lafiyar su da halin da suke ciki. Ana buƙatar mutane su yi waɗannan sharuɗɗa yau da kullum - wasu daga cikinsu na iya zama da muhimmanci sosai ga rayuwa mai kyau, kamar su taya masu kyau don motarka.
- Matalauci za su rasa talauci (ko mutu) kuma masu arziki za su sami wadata (ko rayuwa). Kudin da ake yi na duba CT ya bambanta, amma a gaba ɗaya yana cikin iyakar $ 350. Wasu mutane a kan Medicare zasu iya biyan wannan adadin, yayin da wasu ba za su iya ba. Nazarin sun gano cewa mutane ba su iya yin gwaje-gwajen gwaje-gwaje don gano cutar ba a lokacin da suke biya shi daga aljihun, kuma musamman lokacin da kudin zai bukaci su bar wani abu, misali, abinci.
- Adalci. Zai zama rashin adalci bisa ga abubuwan da aka rubuta a sama, cewa waɗanda ke da hadari don ciwon huhu na huhu ba a bi da su daidai ba. Kamar yadda Martin Luther King ya ce, " Hukuncin adalci a ko'ina yana barazana ga adalci a ko'ina ." Wace irin barazanar da ake fuskanta a kula da lafiyar jama'armu?
Ƙaddamar da shi Up da Matakai na gaba
Idan kai ko ƙaunatacciyar ka sadu da ka'idoji don bincikar cutar kanjamau, akwai bege. Medicare bai riga ya yanke shawara a kan ɗaukar hoto ba. Idan kana da asibiti mai zaman kansa na musamman (ko kuma tsoho ne, tare da sauran masu insurers) kana cikin sa'a. Kamar yadda aka gani a sama da Dokar Kulawa Mai Kulawa yana buƙatar a rufe wadannan allo. Zaɓuɓɓuka idan ba ku da kariya sun haɗa da biyan kuɗi don gwajin. Ko da yake Medicare ba a halin yanzu yana binciko kwayar cutar kanjamau ba, kana da damar da za a gwada gwaji kuma ka biya kansa. Idan an gano ciwon huhu na huhu a lokacin da kake biya bashin gwaji, Medicare za a buƙaci ku biya don kulawa.
> Sources
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