Winawer S J, Miller D
Bull World Health Organ. 1987;65(1):105-11.
Colorectal cancer is a good candidate for secondary prevention strategies. It appears to have a long lead time since most, if not all, of these cancers arise from premalignant adenomas, and several screening methods are available that might detect the cancer in a very early stage. However, there is little evidence at present to show that the available methods of early detection will actually decrease the mortality from colorectal cancer of a screened population as compared to a non-screened population. Studies that might convincingly provide this evidence are still in progress. This paper critically reviews the natural history of colorectal cancer, risk factors, screening trials and treatment.
结直肠癌是二级预防策略的理想对象。由于这些癌症中的大多数（即便不是全部）都起源于癌前腺瘤，所以似乎有很长的前期时间，并且有几种筛查方法可供使用，这些方法可能在非常早期阶段检测到癌症。然而，目前几乎没有证据表明，与未筛查人群相比，现有的早期检测方法实际上会降低筛查人群的结直肠癌死亡率。可能令人信服地提供这一证据的研究仍在进行中。本文对结直肠癌的自然史、危险因素、筛查试验和治疗进行了批判性综述。
