Senior Lecturer in Gastroenterology, Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK.
Ther Adv Med Oncol. 2011 Nov;3(6):269-77. doi: 10.1177/1758834011419550.
Worldwide, colorectal cancer causes 610,000 deaths annually with 38,000 new cases diagnosed in the UK and 16,000 deaths each year. The prognosis is directly related to the staging of the cancer at diagnosis, with an overall 5-year survival rate of approximately 50%. However, for localized disease the figure is much higher at 90%, although unfortunately many cancers present at an advanced stage. Importantly, there is the potential to reduce the incidence because most tumours arise from premalignant adenomatous polyps, which if detected and removed interrupts the adenoma-adenocarcinoma sequence. In addition, identifying colorectal cancer at an early stage can impact on the mortality rates for this neoplasm. The current screening options for bowel cancer include analysis of stool for occult blood and endoscopic assessments of the colorectum, including flexible sigmoidoscopy and full colonoscopy. The aim of this review is to present information on the natural history of colorectal cancer, the evaluation of the different screening modalities and the current faecal occult blood screening program within the UK National Health Service, and to discuss how dietary factors and aspirin may affect aetiology.
在全球范围内，结直肠癌每年导致 61 万人死亡，英国每年新诊断出 3.8 万例，每年有 1.6 万人死亡。预后与诊断时癌症的分期直接相关，总体 5 年生存率约为 50%。然而，对于局部疾病，这一数字要高得多，约为 90%，尽管不幸的是，许多癌症处于晚期。重要的是，由于大多数肿瘤源自癌前腺瘤性息肉，如果发现并切除这些息肉，就可以阻断腺瘤-腺癌序列，因此有可能降低发病率。目前结直肠癌的筛查选择包括粪便潜血分析和结直肠内镜检查，包括乙状结肠镜检查和全结肠镜检查。本文旨在介绍结直肠癌的自然史、不同筛查方法的评估以及英国国民保健制度中当前的粪便潜血筛查计划，并讨论饮食因素和阿司匹林如何影响病因。
