Binciken Ciwon Daji

**Binciken ciwon daji** yana nufin gano, cewon  kansa kafin bayyanar cututtuka.  Wannan na iya haɗawa da gwajin jini, gwajin fitsari, gwajin DNA, da koma, wasu gwaje-gwaje, ko hoton likita . Amfanin dubawa cikin sharuddan rigakafin ciwon daji, gano wuri da wuri da Kuma magani na gaba dole ne a auna shi da kowane lahani.

Nunawa na duniya, wanda kuma aka sani da gwajin taro ko tantance yawan jama'a, ya haɗa da tantance kowa, yawanci a cikin takamaiman rukunin shekaru. Zaɓen tantancewa yana gano mutanen da aka san suna cikin haɗarin kamuwa da cutar kansa, kamar mutanen da ke da tarihin iyali na ciwon ddaji.

Nunawa na iya haifar da sakamako mai kyau na ƙarya da hanyoyin ɓarna na gaba. Hakanan dubawa na iya haifar da sakamako mara kyau na ƙarya, inda aka rasa ciwon daji da ke wanzu. Rikici yana tasowa lokacin da ba a bayyana ba idan fa'idodin tantancewar sun zarce kasadar tsarin tantancewar da kanta, da kuma duk wani gwaji da jiyya na bin diddigi.

Gwaje-gwajen nunawa dole ne su kasance masu tasiri, lafiyayye, jurewa da kyau tare da ƙarancin ƙima na sakamako mara kyau na ƙarya . Idan an gano alamun ciwon daji, ana yin ƙarin gwaje-gwaje masu mahimmanci da ɓarna don isa ga ganewar asali. Yin gwajin cutar kansa zai iya haifar da rigakafin cutar kansa da kuma ganewar asali a baya. Ganewar asali na farko na iya haifar da ƙarin ƙimar magani mai nasara da tsawaita rayuwa. Duk da haka, yana iya zama ƙarya don ƙara lokacin mutuwa ta hanyar nuna son kai ko tsayin lokaci .

## Amfanin likitanci
Manufar gwajin cutar kansa ita ce samar da bayanan lafiya masu amfani waɗanda za su iya jagorantar jiyya.  Binciken na iya taimakawa wajen gano ciwon daji a farkon matakai. Kyakkyawan gwajin cutar kansa ba zai zama mafi kusantar haifar da lahani ba fiye da samar da bayanai masu amfani. Gabaɗaya, gwajin cutar kansa yana da haɗari kuma bai kamata a yi shi ba sai da alamar likita .

Daban-daban hanyoyin duban cutar kansa suna da haɗari daban-daban, amma gwaje-gwaje masu kyau suna raba wasu halaye. Idan gwajin ya gano ciwon daji, to sakamakon gwajin shima yakamata ya haifar da zabin magani. Gwaje-gwaje masu kyau sun zo tare da bayanin majiyyaci na dalilin da yasa wannan mutumin yana da isasshen haɗarin kansa don tabbatar da gwajin. Wani ɓangare na ƙwarewar gwaji shine don mai ba da kiwon lafiya don bayyana yadda sakamakon tabbataccen ƙarya na gama gari ya kasance don majiyyaci ya fahimci mahallin sakamakon su. Idan akwai gwaje-gwaje da yawa, to yakamata a gabatar da gwajin gwaji tare da wasu zaɓuɓɓuka.

## Hatsari
Binciken cutar kansa yana da cece-kuce a lokuta lokacin da har yanzu ba a san ko gwajin ya ceci rayuka ba. Nunawa na iya haifar da ingantaccen sakamako na gaskiya na ƙarya da kuma hanyoyin cin zarafi na gaba. Rigimar ta taso lokacin da ba a bayyana ba idan fa'idodin tantancewar sun zarce haɗarin gwaje-gwajen bincike na bin diddigin da kuma maganin ciwon daji. Ba a nuna gwajin cutar kansa ba sai dai idan tsawon rayuwa ya wuce shekaru biyar kuma amfanin ba shi da tabbas fiye da shekaru 70.

Ana la'akari da abubuwa da yawa don tantance ko fa'idodin tantancewar sun zarce kasada da tsadar aikin tantancewar. Waɗannan abubuwan sun haɗa da:

* Matsalolin da za a iya samu daga gwajin nunawa: Wasu nau'ikan gwaje-gwajen nunawa, kamar hotunan X-ray, suna fallasa jiki ga radiation ionizing mai cutarwa. Akwai ƙaramin damar cewa radiation a cikin gwajin zai iya haifar da sabon ciwon daji a cikin mutum mai lafiya. Binciken mammography, wanda ake amfani da shi don gano ciwon nono, ba a ba da shawarar ga maza ko matasa mata ba saboda suna iya cutar da su ta hanyar gwajin fiye da amfana da shi. Sauran gwaje-gwaje, kamar duban fata don ciwon daji, ba su da wani babban haɗari na cutarwa ga majiyyaci. Gwajin da ke da babban lahani ana ba da shawarar ne kawai lokacin da fa'idodin kuma ya yi yawa.
* Yiwuwar gwajin gano kansa daidai: Idan gwajin ba shi *da hankali*, to yana iya rasa kansa. Idan gwajin ba *takamaiman* ba, to yana iya kuskure ya nuna ciwon daji a cikin mutum mai lafiya. Duk gwaje-gwajen gwajin cutar kansa suna haifar da abubuwan da suka dace na ƙarya da na ƙarya, kuma galibi suna samar da ƙarin tabbataccen ƙarya. Masana sunyi la'akari da adadin kurakurai lokacin yin shawarwari game da gwajin, idan akwai, don amfani. Gwaji na iya yin aiki mafi kyau a wasu jama'a fiye da wasu. Ƙimar tsinkaya mai kyau ita ce ƙididdige yiwuwar cewa sakamakon gwaji mai kyau yana wakiltar ciwon daji a cikin wani mutum da aka ba shi, bisa sakamakon mutanen da ke da irin abubuwan haɗari.
* Yiwuwar ciwon kansa ya kasance: Binciken ba ya da amfani ga cututtukan daji da ba kasafai ba. Ba kasafai ake yi wa matasa ba, tunda ciwon daji cuta ce da ake samu a cikin mutanen da suka haura shekaru 50. Kasashe galibi suna mai da hankali kan shawarwarin tantancewarsu kan manyan nau'ikan cutar kansar da ake iya magancewa da ake samu a yawan al'ummarsu. Alal misali, {asar Amirka ta ba da shawarar yin nazari na duniya don ciwon daji na hanji, wanda ya zama ruwan dare a Amurka, amma ba don ciwon ciki ba, wanda ba shi da yawa; Sabanin haka, Japan ta ba da shawarar auna cutar kansar ciki, amma ba cutar kansar hanji ba, wadda ba ta da yawa a Japan. Shawarwari na tantancewa sun dogara da haɗarin mutum, tare da mutanen da ke da haɗari waɗanda ke karɓar gwajin farko da yawa fiye da masu ƙarancin haɗari.
* Matsalolin da za a iya samu daga hanyoyin biyowa: Idan gwajin gwajin ya tabbata, ana yin ƙarin gwaje-gwajen bincike akai-akai, kamar biopsy na nama. Idan gwajin ya haifar da alamun ƙarya da yawa, to, mutane da yawa za su yi amfani da hanyoyin kiwon lafiya marasa buƙata, wasu daga cikinsu na iya zama haɗari.
* Ko akwai maganin da ya dace kuma ya dace: An hana yin gwajin gwaji idan babu ingantaccen magani. Lokacin da ba a sami ingantacciyar magani mai dacewa ba, to, ganewar cutar mai saurin kisa yana haifar da lahani mai mahimmanci na tunani da tunani. Misali, gwajin cutar kansa na yau da kullun bai dace ba a cikin tsoho mai rauni sosai, saboda maganin duk wani ciwon daji da aka gano zai iya kashe majiyyaci.
* Ko ganowa da wuri yana inganta sakamakon jiyya: Ko da lokacin da ake samun magani, wani lokacin ganowa da wuri ba ya inganta sakamakon. Idan sakamakon maganin ya kasance daidai da cewa ba a yi gwajin ba, to, shirin kawai na tantancewa shine ƙara tsawon lokacin da mutum ya rayu tare da sanin cewa yana da ciwon daji. Ana kiran wannan al'amari son zuciya-lokaci . Shirin tantancewa mai fa'ida yana rage adadin shekarun yuwuwar rayuwa da aka rasa (tsawon rayuka) da kuma daidaita rayuwar nakasassu da aka rasa (rayuwar lafiya).
* Ko ciwon daji zai taɓa buƙatar magani: Ganewar ciwon daji a cikin mutumin da kansar ba zai taɓa cutar da shi ba ana kiransa overdiagnosis . Ciwon daji ya fi yawa a tsakanin tsofaffi masu ciwon daji masu saurin girma. Damuwa game da cutar kanjamau ya zama ruwan dare ga ciwon nono da prostate.
* Ko gwajin ya kasance karbuwa ga marasa lafiya: Idan gwajin gwajin yana da nauyi sosai, kamar buƙatar lokaci mai yawa, zafi mai yawa, ko halayen da ba a yarda da su a al'ada ba, to mutane za su ƙi shiga.
* Farashin gwajin: Wasu ƙwararrun Ma'aikata ta Amurka, ta yi watsi da batun kuɗi gaba ɗaya. Yawancin, duk da haka, sun haɗa da nazarin ingancin farashi wanda, duk sauran daidai yake, yana son gwaje-gwaje marasa tsada akan gwaje-gwaje masu tsada, da ƙoƙarin daidaita farashin shirin nunawa akan fa'idodin amfani da waɗannan kuɗi don wasu shirye-shiryen kiwon lafiya . Waɗannan ƙididdigar yawanci sun haɗa da jimillar kuɗin shirin nunawa ga tsarin kiwon lafiya, kamar ba da odar gwaji, yin gwajin, bayar da rahoton sakamakon, da biopsies don sakamakon da ake tuhuma, amma ba yawanci farashin mutum ba, kamar na ɗan lokaci da aka ɗauka. nesa da aiki.
* Matsayin da ake iya magance ciwon daji: idan mutum yana da ƙarancin tsawon rayuwa ko kuma yana cikin matakan ƙarshe na rashin lafiya, to irin wannan majiyyaci na iya samun rayuwa mafi kyau ta hanyar yin watsi da ciwon daji ko da an gano shi. Idan ganewar ciwon daji ba zai haifar da canji a cikin kulawa ba to gwajin ciwon daji ba zai iya haifar da sakamako mai kyau ba. Ƙwararren bincike a cikin wannan yanayin yana faruwa, alal misali, a cikin marasa lafiya da ke fama da cututtuka na ƙarshen zamani da kungiyoyi suna ba da shawarar yin gwajin cutar kansa ga irin waɗannan marasa lafiya.

## Ta nau'in

## Ciwon nono
Binciken ciwon nono shine gwajin likita na asymptomatic, a fili mata masu lafiya don ciwon nono a yunƙurin cimma ganewar asali a baya. Manufar ganowa da wuri shine a nemo ciwon daji lokacin da za'a iya magance shi. An yi amfani da gwaje-gwajen gwaji da yawa, gami da gwaje-gwaje na asibiti da na kai, mammography, gwajin nono na asibiti, jarrabawar nono, thermography, samfurin nama da hoton maganadisu. Mammography ita ce hanyar da aka fi amfani da ita don tantance ciwon nono ga matan da suka kai shekaru 50 zuwa sama. Akwai mammograms na 3D yanzu ana amfani da su kuma ga matan da ke da haɗarin kamuwa da cutar kansar nono suna iya samun MRI.  Ana la'akari da abubuwan haɗari na ciwon nono don yanke shawara idan ana buƙatar gwajin gwaji kuma idan haka ne wanda ya fi dacewa ga mutum.

## Ciwon mahaifa

Binciken mahaifa ta hanyar gwajin Pap ko wasu hanyoyin yana da matukar tasiri wajen ganowa da kuma hana ciwon daji na mahaifa, kodayake akwai haɗarin wuce gona da iri a cikin mata matasa har zuwa shekaru 20 ko sama da haka, waɗanda ke da saurin samun ƙwayoyin cuta da yawa waɗanda ke sharewa. ta halitta. Akwai kewayo mai yawa a cikin shekarun da aka ba da shawarar da za a fara nunawa a duniya. Dangane da ka'idodin Turai na 2010 don gwajin cutar kansar mahaifa, shekarun da za a fara gwajin ya bambanta tsakanin shekaru 20-30, "amma ba fi son kafin shekaru 25 ko 30 ba", ya danganta da nauyin cutar a cikin yawan jama'a da albarkatun da ake da su.

A Amurka adadin ciwon sankarar mahaifa ya kai kashi 0.1 cikin Kashi 100 na mata ‘yan kasa da shekaru 20, don haka kungiyar Cancer ta Amurka da kuma kwalejin likitocin mata na Amurka suna ba da shawarar cewa a fara tantancewar tun daga shekara 21, ba tare da la’akari da shekaru a lokacin jima’i ba. ko wasu halaye masu alaƙa da haɗari. Ga mata masu lafiya masu shekaru 21-29 waɗanda ba su taɓa yin smear mara kyau ba, gwajin cutar kansar mahaifa tare da cytology na mahaifa (Pap smear) ya kamata ya faru kowace shekara 3, ba tare da la’akari da matsayin rigakafin HPV ba. Abin da aka fi so don mata masu shekaru 30-65 shine "gwaji tare", wanda ya haɗa da haɗin gwajin cytology na mahaifa da gwajin HPV, kowane shekaru 5.  Duk da haka, yana da kyau a gwada wannan rukunin shekaru tare da yin gwajin Pap kadai a kowace shekara 3. A cikin matan da suka haura shekaru 65, ana iya dakatar da yin gwajin cutar kansar mahaifa idan babu sakamakon binciken da bai dace ba a cikin shekaru 10 da suka gabata kuma babu tarihin CIN 2 ko sama da haka.

## Ciwon daji na hanji

Binciken ciwon daji na launin fata, idan an yi shi da wuri, yana da *kariya* domin kusan dukkanin ciwon daji na launin fata ya samo asali ne daga ci gaban da ake kira , wanda za'a iya samuwa kuma a cire shi a lokacin colonoscopy (duba *polypectomy colonic* ).

A Amurka M Services Task Force ya bayar da shawarar nunawa ga colorectal ciwon daji ta amfani da fecal occult jini gwaji, sigmoidoscopy, ko colonoscopy, a manya, farko a shekaru 50 da shekaru da kuma ci gaba har shekaru 75 years.  Ga mutane sama da 75 ko waɗanda ke da tsawon rayuwar ƙasa da 10&nbsp;ba a ba da shawarar duba shekaru ba. Sabuwar hanyar enzyme don tantance ciwon daji na launin fata shine gwajin M2-PK, wanda ke iya gano ciwon jini da kuma ciwon daji marasa jini da kuma polyps.  A cikin shekarar 2008, Kaiser Permanente Colorado ya aiwatar da wani shiri wanda ya yi amfani da kira mai sarrafa kansa kuma ya aika da na'urorin gwajin rigakafi na fecal ga marasa lafiya waɗanda suka wuce lokacin gwajin cutar kansar launin fata. Shirin ya kara yawan adadin membobin da suka cancanta da aka tantance da kashi 25 cikin dari.  Multi-Target Stool DNA Test (Cologuard) da Plasma SEPT9 DNA Methylation Test (Epi proColon) an yarda da FDA.

A Ingila, ana yin gwajin manya a duk shekara ta hanyar gwajin jini na faecal a tsakanin shekarun 60 zuwa 74, kuma kwanan nan ya wuce shekaru daga 50 zuwa 74.

## Prostate ciwon daji
Lokacin da ake yin gwajin cutar kansar prostate, gwajin PSA na iya gano ƙananan ciwon daji waɗanda ba za su taɓa zama masu barazanar rai ba, amma da zarar an gano su za su kai ga jiyya. Wannan yanayin, wanda ake kira overdiagnosis, yana sanya maza cikin haɗari don rikitarwa daga jiyya maras muhimmanci kamar tiyata ko radiation. Bibiyar hanyoyin da ake amfani da su don gano cutar kansar prostate ( prostate biopsy ) na iya haifar da illa, gami da zubar jini da kamuwa da cuta. Maganin ciwon daji na prostate na iya haifar da rashin natsuwa (rashin iya sarrafa kwararar fitsari) da tabarbarewar karfin mazakuta (rashin karfin jima'i). A sakamakon haka, a cikin 2012, da Amurka ke hana ayyukan hana daukar nauyin su (USPSF) da takamammen antigen (PSA) don cutar kansa da cutar cututtukan cutar sankara ba, " yayin da kowa ke son taimakawa wajen hana mace-mace daga cutar sankara ta prostate, hanyoyin gwajin PSA na yanzu da kuma maganin ciwon daji da aka gano a allo ba shine amsar ba."

Kwanan nan, Fenton's 2018 bita  (wanda aka gudanar don USPSTF) ya mayar da hankali kan manyan nau'o'in sarrafawa guda biyu masu inganci na farashi da fa'idodin binciken PSA, kuma binciken ya kwatanta al'amurra masu rikitarwa da ke hade da binciken ciwon daji. Fenton ya bayar da rahoton cewa, tantance maza 1,000 a duk shekara hudu na shekaru 13 yana rage mace-mace daga cutar sankara ta prostate da guda ɗaya kawai. Musamman ma, daga cikin waɗancan maza 1,000: 243 sun sami alamar ciwon daji a lokacin gwajin PSA (mafi yawansu sannan suna da biopsy); daga cikinsu, 3 dole ne a kwantar da su a asibiti don matsalolin ƙwayoyin cuta; An gano 35 tare da ciwon gurguwar prostate (saboda haka adadin ƙararrawar ƙarya daga ainihin gwajin PSA shine> 85%); Daga cikin wadancan 35, 3 sun guje wa cutar sankara ta prostate da kuma 1 sun guje wa mutuwa ta hanyar ciwon gurguwar prostate yayin da 9 suka sami rashin ƙarfi ko rashin iya yoyon fitsari saboda jinyarsu sannan 5 sun mutu sakamakon cutar kansar prostate duk da cewa an yi musu magani. A cikin shawarwarin su na 2018, USPSTF ta kiyasta cewa 20% -50% na maza da aka gano da cutar sankara ta prostate bayan ingantaccen gwajin PSA suna da ciwon daji wanda, ko da ba a kula da su ba, ba zai taɓa girma, yadawa, ko cutar da su ba

Yawancin ƙungiyoyin likitocin Arewacin Amurka suna ba da shawarar yanke shawara na keɓaɓɓu game da tantancewa, la'akari da kasada, fa'idodi, da abubuwan da majiyyata suka zaɓa.

## Ciwon daji na huhu
Nazarin bincike don ciwon huhu na huhu an yi shi ne kawai a cikin yawan haɗari masu haɗari, kamar masu shan taba da ma'aikata masu bayyanar da sana'a ga wasu abubuwa. A cikin shekara ta 2010s shawarwarin da hukumomin kiwon lafiya suka bayar suna nuna goyon baya ga gwajin cutar kansar huhu, wanda mai yuwuwa ya zama sananne a cikin ƙasashe masu tasowa.

A watan Disamban shekarar 2013 The Amurka Ayyukan da ke hana ayyukansa (Uspstf) ya ba da shawarar shaidar cutar ta shekara-shekara don karancin ciwon kai lissafta tomography a cikin manya masu shekaru 55 zuwa 80 waɗanda ke da tarihin fakitin shekaru 30 na shan taba kuma a halin yanzu suna shan taba ko kuma sun daina a cikin shekaru 15 da suka gabata. Yakamata a daina tantancewa da zarar mutum bai sha taba ba har tsawon shekaru 15 ko kuma ya sami matsalar lafiya wanda ke da iyakacin tsawon rai ko kuma iyawa ko kuma niyyar yin tiyatar huhu na curative.”

## Ciwon daji na Pancreatic
Gano farkon gano ciwon daji na pancreatic biomarkers an cika shi ta amfani da tsarin rigakafi na tushen SERS. A SERS-base multiplex proteinbiomarker gano dandamali a cikin guntu microfluidic don ganowa ana amfani da shi don gano furotin biomarkers da yawa don tsinkayar nau'in cuta da masu mahimmancin halittu da haɓaka damar ganowa tsakanin cututtuka tare da masu siyar da halittu masu kama (PC, OVC, da pancreatitis). An yarda da cewa gabaɗaya gwajin manyan ƙungiyoyi don ciwon daji na pancreatic ba zai iya yin tasiri a halin yanzu ba, kuma a waje gwaje-gwajen asibiti babu shirye-shirye don wannan. A Turai Society for Medical Oncology bada shawarar yau da kullum nunawa tare da endoscopic duban dan tayi da kuma MRI / CT Dabarar ga waɗanda a babban hadarin daga gaji halittar jini, a layi tare da wasu shawarwari,  wanda zai iya kuma sun hada da CT.  Don tantancewa, ana iya amfani da hanyoyin duban CT na musamman, kamar CT scan multiphase.

Ga matsakaitan mutanen da ke cikin haɗarin, ba a ba da shawarar yin gwaje-gwaje na yau da kullun don ciwon daji na pancreatic ba a halin yanzu. 

## Ciwon daji na baka
Ayyukan rigakafin na Amurka (Uspstf) a cikin 2013 sun gano cewa shaidar ta isa don tantance daidaiton fa'idodi da cutar kansa ba tare da masu samar da kulawa ba. Cibiyar Nazarin Likitocin Iyali ta Amurka ta zo ga irin wannan matsaya yayin da Ƙungiyar Ciwon daji ta Amurka ta ba da shawarar cewa manya sama da shekaru 20 waɗanda ke yin gwajin lafiya na lokaci-lokaci yakamata a bincika kogon baki don ciwon daji. Ƙungiyar Haƙori ta Amurka ta ba da shawarar cewa masu ba da sabis su kasance a faɗake don alamun ciwon daji yayin gwaje-gwaje na yau da kullun.  Wasu ƙungiyoyin likitocin haƙori kuma suna ba da shawarar gwajin cutar kansar baki. 

## Sauran cututtukan daji
Babu isassun shedar da za a ba da shawarar don ko ƙin gwajin cutar kansar fata, da kansar mafitsara . Ba a ba da shawarar yin gwaje-gwaje na yau da kullun don kansar ƙwanƙwasa da kansar kwai ba

## Bincike

## Hoton jiki duka
Ana samun cikakkun sikanin CT na jiki don gwajin cutar kansa, amma irin wannan nau'in hoto na likitanci don bincika cutar kansa a cikin mutane ba tare da bayyananniyar alamun bayyanar ba na iya haifar da matsaloli kamar haɓakar haɓakar ionizing radiation . Koyaya, sikanin maganadisu na maganadisu ( MRI ) ba su da alaƙa da haɗarin radiation, kuma ana ƙididdige sikanin MRI don amfani da su wajen tantance cutar kansa. Akwai babban haɗarin gano abin da ake kira *incidentalomas* - raunuka marasa kyau waɗanda za a iya fassara su azaman ciwon daji kuma suna sanya marasa lafiya cikin haɗari mai yuwuwa ta hanyar bin hanyoyin da za a bi.

## Manazarta

## Ci gaba da karatu

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## Hanyoyin haɗi na waje

* Shirye-shiryen gwajin cutar kansa na NHS
* Bincike don ciwon daji, Cancer Research UK
* Binciken Ciwon daji, Cibiyar Ciwon daji ta Kasa
* Binciken Ciwon daji a eMedicine
* ColonCancerCheck gami da takaddun gaskiya a cikin yaruka 24 a Ma'aikatar Lafiya ta Ontario da Kulawar Tsawon Lokaci
* http://www.scotland.gov.uk/Topics/Health/health/cancer/Cancer-Screening/criteria
* Yadda shawarwarin nunawa suka canza cikin lokaci  daga Ƙungiyar Ciwon daji ta Amirka