2018年翻译资格考试中级笔译模拟题：小肿瘤
汉译英
有时候你可能知道得太多了。健康人群癌症筛查的目的是发现可治疗的小肿瘤，这似乎是值得称赞的，而事实常常也是如此。不过，有时它会导致不必要的治疗。机体自身有一套阻止小肿瘤生长的机制，对那些可用自身机制加以抑制的肿瘤采取治疗非但无益，反而可能造成危害。
以肺癌为例。纽约纪念斯隆-凯特灵癌症研究中心(Memorial Sloan-Kettering Cancer Centre)的彼得•巴赫(Peter Bach)及其同事在本周出版的《美国医学会杂志》(Journal of the American Medical Association)上发表的一项报告中指出，用于症状出现前肺部肿瘤检测的计算机断层扫描技术(computed tomography，CT)虽深受吹捧，但它可能根本无法降低肺癌死亡率，相反会“雪上加霜”。
有关CT用于肺癌筛查的报道始于去年。康奈尔大学克劳迪娅•赫恩施克(Claudia Henschke)和她的同事报道，患者经CT早期诊断为肺癌后，长期生存率显著提高。这一报道轰动一时。她的研究发现，88%的确诊患者10年后仍有望存活。巴赫在另一研究中也发现了类似结果：94%诊断为早期肺癌的患者生存期可达4年。
尽管如此，仅凭生存期的统计数据是无法回答这样一个基本问题的：“与什么相比?”早期诊断无疑可延长生存期，但早期诊断后患者预后必须良好，否则早期诊断就几乎无任何价值。
因此，巴赫对自己的数据进行了更为彻底的分析。他根据非CT检出肺癌的研究结果建立了统计学模型，并假设其研究个体未接受CT筛查，从而对这些个体的预后进行了评估，结果令人失望。
筛查确实可以发现更多的肿瘤病例。五年中，3200人有144人检出肺癌，而预期值仅为44例。不过，尽管这些人得到早期诊断，但发展为晚期肺癌的人数并未减少，死亡人数也无显著下降(预期为39人，实际有38人)。考虑到早期诊断可使行肿瘤切除术的人数增加十倍(预期为11人，实际达109人)，而这种手术风险又大(术后死亡率5%，此外还有20~40%的患者出现严重并发症)，如此一来就有可能造成更大危害。
参考译文
Sometimes you can know too much. The aim of screening healthy people for cancer is to discover tumors when they are small and treatable. It sounds laudable and often it is. But it sometimes leads to unnecessary treatment. The body has a battery of mechanisms for stopping small tumors from becoming large ones. Treating those that would have been suppressed anyway does no good and can often be harmful.
Take lung cancer. A report in this week's Journal of the American Medical Association, by Peter Bach of the Memorial Sloan-Kettering Cancer Centre in New York and his colleagues, suggests that, despite much fanfare around the use of computed tomography (CT) to detect tumors in the lungs well before they cause symptoms, the test may not reduce the risk of dying from the disease at all—indeed, it may make things worse.
The story begins last year, when Claudia Henschke of Cornell University and her colleagues made headlines with a report that patients whose lung cancer had been diagnosed early by CT screening had excellent long-term survival prospects. Her research suggested that 88% of patients could expect to be alive ten years after their diagnosis. Dr Bach found similar results in a separate study. In his case, 94% of patients diagnosed with early-stage lung cancer were alive four years later.
Survival data alone, though, fail to answer a basic question: “compared with what?” People are bound to live longer after their diagnosis if that diagnosis is made earlier. Early diagnosis is of little value unless it results in a better prognosis.
Dr Bach, therefore, interrogated his data more thoroughly. He used statistical models based on results from studies of lung cancer that did not involve CT screening, to try to predict what would have happened to the individuals in his own study if they had not been part of that study. The results were not encouraging.
Screening did, indeed, detect more tumors. Over the course of five years, 144 cases of lung cancer were picked up in a population of 3,200, compared with a predicted number of 44. Despite these early diagnoses, though, there was no reduction in the number of people who went on to develop advanced cancer, nor a significant drop in the number who died of the disease (38, compared with a prediction of 39). Considering that early diagnosis prompted a tenfold increase in surgery aimed at removing the cancer (the predicted number of surgical interventions was 11; the actual number was 109), and that such surgery is unsafe—5% of patients die and another 20-40% suffer serious complications—the whole process seems to make things worse.
