Kiran P R, Glass R E
Princess Margaret Hospital, Swindon, UK.
Ann R Coll Surg Engl. 2002 Nov;84(6):381-5. doi: 10.1308/003588402760978157.
The 5-year survival rates for colorectal cancer are generally lower in the UK than other European countries. In an attempt to improve prognosis, central government has stipulated that patients with suspicious symptoms ought to be seen within 2 weeks of referral from a primary care physician. In order to evaluate whether symptom duration affects stage at presentation of colorectal cancer, a retrospective analysis of all patients presenting over a 2-year period to a large district general hospital was performed. There was no significant difference (P = 0.885) in Dukes' staging in patients with symptoms lasting less or more than 6 months. Though seeing patients with symptoms suspicious of colorectal cancer in specialist out-patient clinics within 2 weeks of presentation to the primary care physician would probably reduce the number of patients presenting as an emergency, it is unlikely to improve prognosis. Thus funds diverted towards the 2-week wait are probably best utilised for other procedures such as colonoscopy and for improving care once the diagnosis of cancer has been made. Diagnosis of colorectal cancer at an earlier stage is best achieved by screening of the population.
在英国，结直肠癌的5年生存率总体上低于其他欧洲国家。为了改善预后，中央政府规定，出现可疑症状的患者应在初级保健医生转诊后的2周内就诊。为了评估症状持续时间是否会影响结直肠癌确诊时的分期，对一家大型地区综合医院在两年内接诊的所有患者进行了回顾性分析。症状持续时间少于或多于6个月的患者在Dukes分期上没有显著差异（P = 0.885）。尽管在初级保健医生接诊患者后的2周内，在专科门诊为疑似结直肠癌症状的患者看病可能会减少作为急诊就诊的患者数量，但不太可能改善预后。因此，转用于2周等待期的资金可能最好用于其他程序，如结肠镜检查，以及在癌症确诊后改善护理。通过人群筛查能最好地实现结直肠癌的早期诊断。
