Early diagnosis has become one of the most fundamental precepts of modern medicine. It is thought to be the best way to keep people healthy: to find out if they have (pick one) heart disease, autism, diabetes, vascular problems, osteoporosis or, of course, cancer—early.
Recently, however, there have been rumblings within the medical profession that suggest that the enthusiasm for early diagnosis may be waning. Most prominent are recommendations against prostate cancer screening for healthy men and for reducing the frequency of breast and cervical cancer screening. Some experts even cautioned against the recent colonoscopy results, pointing out that the study participants were probably much healthier than the general population, which would make them less likely to die of colon cancer.
The basic strategy behind early diagnosis is to encourage the well to get examined—to determine if they are not, in fact, sick. But is looking hard for things to be wrong a good way to promote health? The truth is, the fastest way to get heart disease, autism, diabetes, vascular problems, osteoporosis or cancer... is to be screened for it. In other words, the problem is overdiagnosis and overtreatment.
Screening the apparently healthy potentially saves a few lives. But it definitely drags many others into the system needlessly—into needless appointments, needless tests, needless drugs and needless operations (not to mention all the accompanying needless insurance forms). This process doesn’t promote health; it promotes disease. People suffer from more anxiety about their health, from drug side effects, from complications of surgery. A few die. And remember: these people felt fine when they entered the health care system.
Increasingly we operate under the early diagnosis precept: seeking diagnosis and initiating therapy in people who are not experiencing problems. That’s a huge change in approach, from one that focused on the sick to one that focuses on the well. Some doctors have long recognized that the approach is a distraction for the medical community. It’s easier to transform people into new patients than it is to treat the truly sick. It’s easier to develop new ways of testing than it is to develop better treatments. And it’s a lot easier to measure how many healthy people get tested than it is to determine how well doctors manage the chronically ill.
The rumblings show that that’s beginning to change. Let me be clear: early diagnosis is not always wrong. The question is how often and how far we should get ahead of symptoms.
For years now, people have been encouraged to look to medical care as the way to make them healthy. But that’s your job—you can’t contract that out. Doctors might be able to help, but so might an author of a good cookbook, a personal trainer, a cleric or a good friend. We would all be better off if the medical system got a little closer to its original mission of helping sick patients, and let the healthy be.
1. According to the author, what is the problem with the early diagnosis?
2. Why does the screening promote disease according to the passage?
3. What can we learn about the “huge change in approach”?
4. Why does the author mention what doctors have long found out?
5. What is the best title for the passage?
问题1选项
A.The public find out the screening is not as accurate as expected.
B.Certain diseases can’t be screened out by early diagnosis.
C.Too much early screening pushes people into sickness instead of health.
D.Early diagnosis is wrongly placed as the best perception of modern medicine.
问题2选项
A.Some fatal diseases will be found out through screening.
B.Patients can’t afford to wait for the results of screening.
C.They have to fill in endless forms to ensure their screening.
D.Patients have to suffer needless damages mentally and physically.
问题3选项
A.Doctors focus on the people who have problems instead of patient-to-be now.
B.Doctors have to focus on the prevention by early screening instead of treatment now.
C.We shouldn’t treat patients until they begin to have problems before.
D.People are encouraged to stay at home until they have problems.
问题4选项
A.To suggest doctors are very unsatisfied with the early diagnosis.
B.To justify why doctors can’t give best treatment sometimes.
C.To prove hospitals should invest much on equipment for testing.
D.To imply there will be negative impact on the judgments criteria of hospital.
问题5选项
A.Early screening: angel, or devil?
B.Overtreatment: never too late to dump it
C.Good hospital: focus on treatment
D.Prevention: don’t go too far
第1题:C
第2题:D
第3题:B
第4题:D
第5题:A
第1题:
【选项释义】
According to the author, what is the problem with the early diagnosis? 根据作者的说法，早期诊断的问题是什么？
A. The public find out the screening is not as accurate as expected. A. 公众发现筛查并不像预期的那样准确。
B. Certain diseases can’t be screened out by early diagnosis. B. 某些疾病不能通过早期诊断筛查出来。
C. Too much early screening pushes people into sickness instead of health. C. 过多的早期筛查将人们推向疾病而不是健康。
D. Early diagnosis is wrongly placed as the best perception of modern medicine. D. 早期诊断被错误地定位为现代医学的最佳认知。
【考查点】事实细节题。
【解题思路】根据题干关键词problem with the early diagnosis可以定位到文章第三段最后一句“换句话说，问题在于过度诊断和过度治疗（overdiagnosis and overtreatment）”和第四段第三句“这个过程不会促进健康（doesn’t promote health）；它会引发疾病（promotes disease）”，说明早期诊断的问题在于让人们进行过多不必要的诊断和治疗，不但没有促进健康，反而会引发疾病。因此C选项“过多的早期筛查将人们推向疾病而不是健康。”正确。
【干扰项排除】
A选项“公众发现筛查并不像预期的那样准确。”和B选项“某些疾病不能通过早期诊断筛查出来。”在文中没有提及，属于无中生有；
D选项“早期诊断被错误地定位为现代医学的最佳认知。”，由It is thought to be the best way to keep people healthy（它被认为是保持人们健康的最好方法）可知，人们认为它是保持健康的最好方法，而不是现代医学的最佳认知，属于偷换概念。
第2题:
【选项释义】
Why does the screening promote disease according to the passage? 根据这篇文章，为什么筛查会引发疾病？
A. Some fatal diseases will be found out through screening. A. 一些致命的疾病会通过筛查被发现。
B. Patients can’t afford to wait for the results of screening. B. 病人不能等待筛查的结果。
C. They have to fill in endless forms to ensure their screening. C. 他们必须填写无尽的表格以确保他们的筛查。
D. Patients have to suffer needless damages mentally and physically. D. 病人不得不在精神上和生理上遭受不必要的损害。
【考查点】事实细节题。
【解题思路】根据题干关键词promote disease可以定位到文章第四段第三、四、五句“这个过程不会促进健康；它会引发疾病（promote health）。人们对自己的健康、对药物的副作用、对手术的并发症感到更加焦虑（suffer from more anxiety）。一些人死了（A few die）”，说明筛查会引发疾病的原因在于人们在筛查后遭受了精神和生理上的折磨，这些折磨本来是不必经受的。因此D选项“病人不得不在精神上和生理上遭受不必要的损害。”正确。
【干扰项排除】
A选项“一些致命的疾病会通过筛查被发现。”与筛查引发疾病无关，属于出处错位；
B选项“病人不能等待筛查的结果。”在文中没有提及，属于无中生有；
C选项“他们必须填写无尽的表格以确保他们的筛查。”，由not to mention all the accompanying needless insurance forms（更不用说那些随之而来的不必要的保险表格）可知，填写无尽的表格是为了说明早期诊断的不必要性，与筛查引发疾病无关，属于出处错位。
第3题:
【选项释义】
What can we learn about the “huge change in approach”? 关于“方法上的巨大改变”，我们可以了解到什么？
A. Doctors focus on the people who have problems instead of patient-to-be now. A. 医生们现在关注的是有问题的人，而不是准病人。
B. Doctors have to focus on the prevention by early screening instead of treatment now. B. 现在，医生的重点应该是通过早期筛查来预防，而不是治疗。
C. We shouldn’t treat patients until they begin to have problems before. C. 我们不应该在病人开始出现问题之前治疗他们。
D. People are encouraged to stay at home until they have problems. D. 鼓励人们待在家里直到他们出现问题。
【考查点】事实细节题。
【解题思路】根据题干关键词huge change in approach可以定位到文章第五段第二句“这是一个方法上的巨大改变（a huge change in approach），从关注病人（focused on the sick）到关注健康人（focuses on the well）”，说明巨大的改变是指从重点关注治疗病人转为通过早期筛查关注健康人的疾病预防。因此B选项“现在，医生的重点应该是通过早期筛查来预防，而不是治疗。”正确。
【干扰项排除】
A选项“医生们现在关注的是有问题的人，而不是将成为病人的人。”，由from one that focused on the sick to one that focuses on the well（从关注病人到关注健康人）可知，医生现在关注的不是已经生病的人，属于反向干扰；
C选项“我们不应该在病人开始出现问题之前治疗他们。”，由The question is how often and how far we should get ahead of symptoms.（问题是我们应该多久以及在多大程度上预防症状。）可知，作者没有完全反对早期诊断，只是认为需要注意程度，属于过度推断；
D选项“鼓励人们待在家里直到他们出现问题。”在文中没有提及，属于无中生有。
第4题:
【选项释义】
Why does the author mention what doctors have long found out? 为什么作者提到医生早就发现的问题？
A. To suggest doctors are very unsatisfied with the early diagnosis. A. 暗示医生对早期诊断非常不满意。
B. To justify why doctors can’t give best treatment sometimes. B. 为了证明医生有时不能给予最佳治疗的原因。
C. To prove hospitals should invest much on equipment for testing. C. 证明医院应该在检测设备上进行大量投资。
D. To imply there will be negative impact on the judgments criteria of hospital. D. 暗示对医院的评判标准会有负面影响。
【考查点】推理判断题。
【解题思路】根据题干关键词doctors have long found out可以定位到文章第五段第三句“一些医生早就认识到，这种方法会分散医学界的注意力（a distraction for the medical community）”，说明医生早就发现的问题是早期诊断会分散医学界的注意力，其影响是下文说到的“把人变成新病人比治疗真正的病人容易得多。开发新的检测方法要比开发更好的治疗方法容易。衡量有多少健康的人接受了测试，比确定医生对慢性病患者的管理水平要容易得多”，由此可推断因为医院关注的重点发生了改变，所以评价一个医院的标准也会产生负面的改变。因此D选项“暗示对医院的评判标准会有负面影响。”正确。
【干扰项排除】
A选项“暗示医生对早期诊断非常不满意。”，B选项“为了证明医生有时不能给予最佳治疗的原因。”和C选项“证明医院应该在检测设备上进行大量投资。”在文中均没有提及，属于无中生有。
第5题:
【选项释义】
What is the best title for the passage? 这篇文章的最佳标题是什么？
A. Early screening: angel, or devil? A. 早期筛查：是天使，还是魔鬼？
B. Overtreatment: never too late to dump it B. 过度治疗：甩掉它永远不会太晚
C. Good hospital: focus on treatment C. 好医院：专注于治疗
D. Prevention: don’t go too far D. 预防：不要走得太过
【考查点】主旨大意题。
【解题思路】文章首先提出早期诊断这一治疗手段，介绍了它在提前发现疾病方面的作用，接着阐述了早期诊断存在的问题，过度诊断和过度治疗反而会引发疾病，而且会让医生和医院从关注病人转变为更关注健康人，最后表明了作者的态度，并非完全不认可早期诊断，只是要注意程度，医疗系统还是要回归其最初的使命——帮助病人，由此可知本文是对早期诊断的一个客观分析，既介绍了它的好处，也指出了它的问题。因此A选项“早期筛查：是天使，还是魔鬼？”正确。
【干扰项排除】
B选项“过度治疗：甩掉它永远不会太晚”，C选项“好医院：专注于治疗”和D选项“预防：不要走得太过”分别只提到了文章的某一个部分，不能概括全文的主旨大意，属于以偏概全。
【参考译文】
早期诊断已成为现代医学最基本的原则之一。它被认为是保持人们健康的最佳方法：及早发现他们是否患有（选择一种）心脏病、自闭症、糖尿病、血管问题、骨质疏松症，当然还有癌症。
然而，最近医学界出现了一些声音，表明人们对早期诊断的热情可能正在减退。最显著的是建议不要对健康男性进行前列腺癌筛查，并减少乳腺癌和宫颈癌筛查的频率。一些专家甚至对最近的结肠镜检查结果提出警告，指出参与研究的人可能比普通人健康得多，因此他们死于结肠癌的可能性较低。
早期诊断的基本策略是鼓励健康者接受检查，以确定他们是否真的生病了。但是，努力寻找问题所在是促进健康的好方法吗？事实上，得心脏病、自闭症、糖尿病、血管问题、骨质疏松症或癌症最快的方法就是接受筛查。换句话说，问题在于过度诊断和过度治疗。
对表面上健康的人进行筛查可能会挽救一些人的生命。但它肯定会把许多人不必要地拖进这个系统——不必要的预约、不必要的检查、不必要的药物和不必要的手术（更不用说所有随之而来的不必要的保险表格了）。这个过程并不能促进健康，反而会助长疾病。人们对自己的健康更加焦虑，遭受药物副作用和手术并发症的折磨。少数人因此死亡。请记住：这些人在进入医疗系统时感觉良好。
我们越来越多地根据早期诊断原则开展工作：对没有问题的人寻求诊断并开始治疗。这是一个巨大的方法变革，从关注病人到关注健康人。一些医生早就认识到，这种方法会分散医学界的注意力。把人变成新病人比治疗真正的病人更容易。开发新的检测方法比开发更好的治疗方法更容易。衡量有多少健康人接受了检测，比确定医生对慢性病患者的管理水平要容易得多。
种种迹象表明，这种情况正在开始改变。让我明确一点：早期诊断并不总是错误的。问题是我们应该多频繁、多大程度地提前发现症状。
多年来，人们一直被鼓励将医疗保健作为使自己健康的途径。但这是你的工作，你不能把它承包出去。医生也许能帮上忙，但一本好食谱的作者、私人教练、牧师或好朋友也能帮上忙。如果医疗系统能更贴近其最初的使命——帮助生病的病人，而让健康的人保持健康，我们都会过得更好。
