Oncology Frontier : The underlying theme is early detection. One important point that was brought out at that discussion last evening about the global prevalence of breast cancer is that there is a cultural need to be aware of the gender of the physician， to encourage women to have that early detection. Can you speak more about that?

　　《肿瘤瞭望》：非常关键的一点就是早期发现。昨晚有关全球乳腺癌患病率的会议日程中探讨的非常重要的一点就是，从文化角度而言，医生性别对鼓励女性进行乳腺癌早期筛查至关重要。能否请您详细谈一下这一点？

　　Dr. Anderson : Well， the point that was made in the session that in many cultures， the male and female boundaries are such that women will be very uncomfortable if their physician is male when you are talking about something personal like their breasts. That is a debated point. This is often said about the Middle East and it is a debated point because it is not entirely clear whether they do not go because it is a male physician or because they do not go because there really is nobody to see. That may not be the same boundary in China. It is interesting that within the Shanghai Self Examine trial， this was a trial that was run from about 1992 to 2002， and in that trial it was done in Shanghai， and women were either trained in self examination of their breast or they were observed without this training. What they found was there was little difference between the women who were trained in self examination and women who were not. The incorrect conclusion from that trial that is often quoted was that it means that self examination does not work. That is not what the trial says at all. What the trial showed was that training women in self examination as opposed to letting them self discover lumps worked about the same， at least in Shanghai， and it is very notable that the Chinese women in Shanghai in the control group (those not trained specifically in how to do self exam) did really well. In fact 40% of the women when they had cancer， found their cancers when it was still smaller than 2 cm. That is a T1 lesion and that is a very successful cancer identification rate and really it is much better than we see in Africa or we see in Latin America. It seems like the women are quite good at self discovery and in the textile factories of Shanghai where this work was done， the women in both groups seem to access their healthcare system quite quickly and get them addressed properly. I think actually that male gender issue， I cannot speak to Chinese women specifically， but they seem to be making their way forcefully into the system and being treated appropriately， very much to their credit.

　　Anderson教授：会议上指出，很多文化中认为男女有别，因此面对男性医生时女性接受乳腺癌筛查会很不自在。在某些文化背景下，异性医生与患者讨论乳腺备受争论。例如在中东地区，女性面临男医生时可能不接受筛查。中国可能也存在同样情况。非常有趣的是，1992~2002年在上海开展的自我评估试验中，受试女性在接受或不接受乳腺自我评估培训的基础上进行乳腺癌相关筛查和检查，结果发现，两组受试者之间并无太大差别。有些人会错误地认为自我乳腺检查或评估没有意义。实际上从试验本身来看，并不能得出这一结论。该试验表明，至少在上海女性中，自我评估培训与让其自己发现肿块效果一样。需强调的是，没有接受自我评估培训的对照组上海女性也做得非常好。实际上，40%的女性在罹患癌症后，会在癌症不足2 cm时发现。这时候病变仍处于T1期，实际上已实现了癌症的成功早期识别，这种情况比非洲或拉丁美洲好很多。似乎女性在乳腺癌自我发现方面做得已相当不错，在上海纺织工厂进行该试验的女性中，两组受试者都能非常快速的到医疗保健系统就诊，从而使其所发现的问题得到妥善处理。我认为，男性性别问题在中国女性中并不严重。实际上，中国女性似乎能尽力去医疗系统就诊，并得到适宜治疗。