O'Sullivan B, Gospodarowicz M, Mackillop W J, Evans W K, Whylie B, Ashbury F D
Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Ontario.
Cancer Prev Control. 1998 Dec;2(6):287-94.
The lack of uniform recording of stage is a continued barrier to the success of cancer control activities. To review the role of staging, in 1997 the Canadian Committee on Cancer Staging (CCCS) of the National Cancer Institute of Canada (NCIC) formalised a national Consultation initiative with the input of Canadian oncology leaders and international experts on staging. A document was created from prior background work by the Committee and pre-circulated for comment. The document described the importance of cancer staging to patient care, epidemiological and clinical research, and cancer control programs. The document was refined through an iterative process over much of a year which included a formal workshop of the participants and other meetings. The Consultation reaffirmed, with evidence, the central role of staging in all aspects of cancer management. The report of the Consultation, endorsed by the Board of Directors of NCIC, included the following recommendations: 1) the recording of TNM stage by the treating physician should be a standard of care for every cancer patient in Canada where TNM applies, 2) the Canadian Council on Health Services Accreditation should include the TNM stage for every cancer patient as a requirement for hospital accreditation. In conclusion, this process represents an effective method for raising awareness about important medical issues such as staging which are fundamental to the management and control of cancer.
癌症分期记录缺乏统一标准,仍然是癌症控制活动取得成功的一大障碍。为了审视分期的作用,1997年,加拿大国家癌症研究所(NCIC)的加拿大癌症分期委员会(CCCS)在加拿大肿瘤学领军人物和国际分期专家的参与下,发起了一项全国性咨询倡议。该委员会根据之前的背景工作编写了一份文件,并预先分发以征求意见。这份文件阐述了癌症分期对患者护理、流行病学和临床研究以及癌症控制项目的重要性。经过一年多的反复修改,包括举办一次正式的研讨会和召开其他会议,这份文件得以完善。此次咨询有证据地重申了分期在癌症管理各个方面的核心作用。经NCIC董事会认可的咨询报告提出了以下建议:1)在适用TNM分期的情况下,主治医生记录TNM分期应成为加拿大每位癌症患者的护理标准;2)加拿大卫生服务认证委员会应将每位癌症患者的TNM分期纳入医院认证要求。总之,这一过程是提高对诸如分期这类对癌症管理和控制至关重要的重要医学问题认识的有效方法。