Zbar Andrew P, Inniss Michael, Prussia Patsy R, Shenoy Radhakanth
Department of Surgery, School of Clinical Medicine and Research, The University of the West Indies, Queen Elizabeth Hospital Barbados, St Michael, Barbados.
Dis Colon Rectum. 2007 Aug;50(8):1215-22. doi: 10.1007/s10350-007-0238-1.
Recent reports have suggested a shift to the right in older female patients of colon cancer. This is believed to be representative of more accessible national endoscopic screening programs.
We report the demographic shift in colorectal cancer based on an analysis of resection specimens during four five-year time periods from 1985 to 2004 at the University Hospital, Barbados. Differences in population-based colorectal cancer incidence, age, gender, site, stage, and presentation (emergency vs. elective) are analyzed.
A total of 1,014 specimens obtained from 993 patients were analyzed, showing a progressive population-based increase in colorectal cancer in Barbados during this 20-year time period. There was an increase in right-sided tumors (P < 0.0001) without a concomitant decline in left-sided tumors. There was a significant increase in Dukes A cancers (P < 0.0001) without gender predilection. During the time period, there was a significant reduction in right-sided tumors presenting as emergencies (P < 0.005) without an effect of stage or gender.
There has been a steady increase in both right-sided and left-sided colonic cancers without gender predilection. The increase in early-stage tumors and reduction in emergency presentations during the latter part of the study suggests value in instituting a formal national colonoscopic screening program to assess its prospective effect on these parameters.
近期报告显示老年女性结肠癌患者的发病部位有右移趋势。这被认为是全国范围内内镜筛查项目可及性提高的体现。
我们通过分析1985年至2004年期间巴巴多斯大学医院四个五年时间段内的切除标本，报告结直肠癌的人口统计学变化。分析基于人群的结直肠癌发病率、年龄、性别、部位、分期及就诊情况（急诊与择期）的差异。
共分析了来自993例患者的1014份标本，结果显示在这20年期间巴巴多斯基于人群的结直肠癌发病率呈逐步上升趋势。右侧肿瘤数量增加（P < 0.0001），而左侧肿瘤数量并未相应减少。Dukes A期癌症显著增加（P < 0.0001），且无性别倾向。在此期间，以急诊形式就诊的右侧肿瘤数量显著减少（P < 0.005），且不受分期或性别的影响。
左右侧结肠癌均呈稳步上升趋势，且无性别倾向。研究后期早期肿瘤数量增加以及急诊就诊情况减少，提示开展正式的全国结肠镜筛查项目以评估其对这些参数的预期效果具有重要意义。
