National Cancer Action Team, St Thomas' Hospital, London, UK.
Br J Cancer. 2009 Dec 3;101 Suppl 2(Suppl 2):S125-9. doi: 10.1038/sj.bjc.6605402.
This supplement presents a wide range of observations, reviews, novel research and analyses underpinning the National Awareness and Early Diagnosis Initiative (NAEDI). The preceding three papers present and discuss different aspects of the data from European cancer survival comparison studies. I conclude here by attempting to quantify the extent to which delayed diagnosis in England accounts for observed survival differences and by outlining areas for further research.
Analysis of indirect evidence related to late diagnosis, surgical intervention rates and utilisation of radiotherapy and chemotherapy in England and other European countries in the late 1990s for breast, colorectal and lung cancer.
Late diagnosis was almost certainly a major contributor to poor survival in England for all three cancers. Low surgical intervention rates are very likely to have contributed to low survival rates for lung cancer and possibly for the other two cancers. Any differences in the use of radiotherapy or chemotherapy are likely to have had only a minor impact on survival differences.
Between 5000 and 10000 deaths within 5 years of diagnosis could be avoided every year in England if efforts to promote earlier diagnosis and appropriate primary surgical treatment are successful. Detailed international benchmarking studies are to be recommended.
本增刊呈现了广泛的观察结果、综述、新的研究和分析，为国家意识和早期诊断倡议（NAEDI）提供了支持。前三篇论文介绍并讨论了欧洲癌症生存比较研究数据的不同方面。我在这里试图量化英格兰延迟诊断在多大程度上导致了观察到的生存差异，并概述了进一步研究的领域。
分析了与英格兰和其他欧洲国家 20 世纪 90 年代晚期乳腺癌、结直肠癌和肺癌的晚期诊断、手术干预率以及放疗和化疗使用率相关的间接证据。
对于所有三种癌症，晚期诊断几乎肯定是导致英格兰生存率低的主要原因。低手术干预率很可能导致肺癌和其他两种癌症的生存率低。放疗或化疗的使用差异可能对生存差异的影响很小。
如果成功地努力促进早期诊断和适当的初级手术治疗，英格兰每年可以避免 5000 到 10000 例在诊断后 5 年内的死亡。建议进行详细的国际基准研究。
