Graffner H, Hallin E, Stridbeck H, Nilsson J
Scand J Prim Health Care. 1986 Nov;4(4):249-51. doi: 10.3109/02813438609014842.
Doctor's delay in patients with rectal carcinoma is common with a frequency between 30% and 60%. The reason for delay has been supposed to be the neglectance to perform digital examination and rigid proctosigmoidoscopy in patients with symptoms of anorectal disease. Especially general practitioners have been blamed for a high percentage of this kind of doctor's delay. In this study 300 consecutive patients referred for radiological examination of the large bowel have been questioned if digital examination and rigid proctosigmoidoscopy have been performed by their referral doctor. The results show that in 19% of the cases neither digital nor proctosigmoidoscopic examination had been performed. Rigid proctosigmoidoscopy had been omitted in 44%. No statistical difference was observed in the frequency of digital examination between general practitioners (79%) and hospital doctors (84%). The low figures, both for digital examination and rigid proctosigmoidoscopy are probably causing many patients a delay in the diagnosis of a rectal carcinoma. Thus, a more intense evaluation in this area should be applied in the medical faculties and also at post graduate courses.
直肠癌患者中医生延误情况很常见，发生率在30%至60%之间。延误的原因据推测是对患有肛肠疾病症状的患者未进行直肠指检和硬性直肠乙状结肠镜检查。尤其是全科医生因这类医生延误的比例较高而受到指责。在本研究中，连续300例被转诊进行大肠放射学检查的患者被询问其转诊医生是否进行了直肠指检和硬性直肠乙状结肠镜检查。结果显示，在19%的病例中，既未进行直肠指检也未进行直肠乙状结肠镜检查。44%的病例未进行硬性直肠乙状结肠镜检查。全科医生（79%）和医院医生（84%）进行直肠指检的频率未观察到统计学差异。直肠指检和硬性直肠乙状结肠镜检查的低数据可能导致许多患者直肠癌诊断延误。因此，医学院校以及研究生课程中应在该领域进行更深入的评估。
