Khuhaprema Thiravud, Srivatanakul Petcharin
National Cancer Institute, Rama VI Road, Ratchathewi, Bangkok 10400, Thailand.
Jpn J Clin Oncol. 2008 Apr;38(4):237-43. doi: 10.1093/jjco/hyn020. Epub 2008 Mar 20.
Cancers of the colon and rectum are rare in developing countries, in contrast to the high incidence rates in countries of Europe, North America, Australia and Japan. Significant differences also exist within continents. Colorectal cancer mortality and incidence rates have decreased in the USA. However, the incidence in Japan and Thailand is rising, probably due to the acquisition of Western lifestyle. Incidence also increases with age: carcinomas are rare before the age of 40 years except in individuals with genetic predisposition or predisposing conditions. The incidence rate of colorectal cancer in Thailand is low when compared with other countries. It is the third in frequency in males after liver and bile duct and lung cancers, and the fifth after cancers of the cervix, breast, liver and bile duct and lung for females. The highest incidence for both sexes is seen in Bangkok. The number of cases of colorectal cancer in both sexes is increasing and will probably exceed that of lung cancer in the next decade. Thus, we are planning to have colorectal cancer screening programme. We should pay more attention on primary and secondary prevention to control colorectal cancer in Asian countries.
与欧洲、北美、澳大利亚和日本等国家的高发病率相比，结肠直肠癌在发展中国家较为罕见。各大洲内部也存在显著差异。美国的结肠直肠癌死亡率和发病率有所下降。然而，日本和泰国的发病率正在上升，这可能是由于西方生活方式的影响。发病率也随年龄增长而增加：除了有遗传易感性或易感疾病的个体外，40岁之前很少发生癌症。与其他国家相比，泰国的结肠直肠癌发病率较低。在男性中，它的发病率仅次于肝癌、胆管癌和肺癌，位列第三；在女性中，仅次于宫颈癌、乳腺癌、肝癌、胆管癌和肺癌，位列第五。男女发病率最高的地区均在曼谷。男女结肠直肠癌病例数都在增加，未来十年可能会超过肺癌病例数。因此，我们正计划开展结肠直肠癌筛查项目。在亚洲国家，我们应更加关注一级和二级预防，以控制结肠直肠癌。
