Lohsiriwat Varut, Lohsiriwat Darin, Thavichaigarn Parinya
Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Asian Pac J Cancer Prev. 2009 Jul-Sep;10(3):467-70.
A significant reduction in colorectal cancer (CRC) mortality is attributed to CRC screening and surveillance. However, there is no national consensus on CRC screening and surveillance in Thailand. The aim of this study was to assess current practice in CRC screening and surveillance among Thai general surgeons.
Between July and November 2008, a questionnaire was randomly sent to general surgeons nationwide, mainly to those who worked in the General Province Hospital or University Hospital. Their responses were analyzed.
One hundred and twelve general surgeons completed questionnaires (56% response rate); about 39% of them were colorectal surgeons. Ninety-four surgeons (84%) routinely offered CRC screening to an asymptomatic, average-risk population. Most surgeons started CRC screening in an average-risk patient at the age of 50 years and did no screening in populations with age above 80 years. Colonoscopy is the most popular investigation used in CRC screening, followed by fecal occult blood testing and double contrast barium enema. When the surgeons themselves were subjected to CRC screening, colonoscopy was also the favorite investigation used. About 3-18% of surgeons showed interest in CRC screening with computed tomographic colonography. After curative CRC resection, most surgeons set up a surveillance program with examinations every 3 months in the first 2 years and performed post-CRC resection surveillance by colonoscopy at 1 year.
There is a wide variation in CRC screening and surveillance among Thai surgeons. These results highlight the need to establish evidence-based and cost-effective CRC screening and surveillance in Thailand.
结直肠癌（CRC）死亡率的显著降低归因于CRC筛查和监测。然而，泰国在CRC筛查和监测方面尚未达成全国共识。本研究的目的是评估泰国普通外科医生在CRC筛查和监测方面的当前实践情况。
2008年7月至11月期间，向全国普通外科医生随机发放问卷，主要发给在省级综合医院或大学医院工作的医生。对他们的回答进行分析。
112名普通外科医生完成了问卷（回复率为56%）；其中约39%为结直肠外科医生。94名外科医生（84%）定期为无症状的平均风险人群提供CRC筛查。大多数外科医生在平均风险患者50岁时开始进行CRC筛查，80岁以上人群不进行筛查。结肠镜检查是CRC筛查中最常用的检查方法，其次是粪便潜血试验和双重对比钡灌肠。当外科医生自己接受CRC筛查时，结肠镜检查也是他们最喜欢的检查方法。约3%-18%的外科医生对计算机断层结肠成像CRC筛查表现出兴趣。在根治性CRC切除术后，大多数外科医生在前两年每3个月进行一次检查建立监测计划，并在术后1年通过结肠镜检查进行CRC切除术后监测。
泰国外科医生在CRC筛查和监测方面存在很大差异。这些结果凸显了在泰国建立基于证据且具有成本效益的CRC筛查和监测的必要性。
