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结直肠癌的特异性和非特异性症状以及与全科医疗的联系

Specific and non-specific symptoms of colorectal cancer and contact to general practice.

作者信息

Rasmussen Sanne, Larsen Pia V, Søndergaard Jens, Elnegaard Sandra, Svendsen Rikke P, Jarbøl Dorte E

机构信息

Research Unit of General Practice, Department of Public Health, University of Southern, Odense, Denmark.

出版信息

Fam Pract. 2015 Aug;32(4):387-94. doi: 10.1093/fampra/cmv032. Epub 2015 May 14.

Abstract

BACKGROUND

To improve survival rates for colorectal cancer, referral guidelines have been implemented. First step in the diagnostic process is for the individual to recognize the symptoms and contact his/her general practitioner (GP) for evaluation.

OBJECTIVES

To determine (i) the prevalence of specific and non-specific symptom experiences indicative of colorectal cancer, (ii) the proportion of subsequent contacts to GPs, (iii) to explore the possible differences in symptom experience and contact to GPs between age and sex.

METHODS

A nationwide study of 100000 adults, aged 20 years and older, were randomly selected in the general population and invited to participate in an internet-based survey. Items regarding experience of specific and non-specific alarm symptoms of colorectal cancer within the preceding 4 weeks and contact to GP were included.

RESULTS

A total of 49706 subjects completed the questionnaire. Abdominal pain was the most common specific alarm symptom (19.7%) and tiredness was the most common non-specific symptom (49.8%). The experiences of symptoms were more common among women and more common in the youngest age groups for both sexes. The symptom leading to the highest proportion of GP contacts was rectal bleeding (33.8%). When experiencing any combination of two specific alarm symptoms, the proportion who contacted a GP was less than 50%. The combination of a non-specific and a specific alarm symptom gave rise to the highest proportion of GP contacts.

CONCLUSION

Although specific and non-specific alarm symptoms of colorectal cancer are common in the general population, the proportion of GP contacts is low.

摘要

背景

为提高结直肠癌的生存率,已实施转诊指南。诊断过程的第一步是个人识别症状并联系其全科医生(GP)进行评估。

目的

确定(i)提示结直肠癌的特异性和非特异性症状经历的患病率,(ii)随后联系全科医生的比例,(iii)探讨年龄和性别在症状经历及联系全科医生方面的可能差异。

方法

在普通人群中随机选取100000名20岁及以上的成年人进行全国性研究,并邀请他们参与基于互联网的调查。问卷内容包括前4周内结直肠癌特异性和非特异性报警症状的经历以及与全科医生的联系情况。

结果

共有49706名受试者完成了问卷。腹痛是最常见的特异性报警症状(19.7%),疲劳是最常见的非特异性症状(49.8%)。症状经历在女性中更常见,在两个性别的最年轻年龄组中也更常见。导致联系全科医生比例最高的症状是直肠出血(33.8%)。当出现两种特异性报警症状的任何组合时,联系全科医生的比例不到50%。非特异性和特异性报警症状的组合导致联系全科医生的比例最高。

结论

尽管结直肠癌的特异性和非特异性报警症状在普通人群中很常见,但联系全科医生的比例较低。

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