Macadam D B
J R Coll Gen Pract. 1979 Dec;29(209):723-9.
stomach, caecum and ascending and transverse colon, sigmoid colon and rectum. The incidence of these cancers in general practice is as rare as three per 10,000 consultations. I report on a study in general practice of the symptoms and delays in diagnosis in 150 patients with gastrointestinal cancer. There was an interval of many weeks between the onset of symptoms and diagnosis in the majority of cases. In approximately 50 per cent of cases there was an interval of weeks between the patient consulting the general practitioner and being referred for hospital investigation. No association was demonstrated between delay and social class, age, physical isolation, or the regular consulting rate of the patient. There was evidence that the consulting rate of some patients with gastrointestinal cancer increased in the 12 months before diagnosis because of the presence of symptoms not specific to the gastrointestinal tract.Much more knowledge of the early symptoms of these cancers is required if the general practitioner is to be able to identify those patients with a high probability of early cancer from others who have symptoms which are common both to non life-threatening conditions and to cancer lesions.
胃癌、盲肠及升结肠和横结肠癌、乙状结肠癌和直肠癌。在普通医疗实践中,这些癌症的发病率低至每10000次诊疗中仅有3例。我报告了一项针对150例胃肠道癌症患者在普通医疗实践中的症状及诊断延误情况的研究。在大多数病例中,症状出现与诊断之间间隔了数周时间。约50%的病例中,患者咨询全科医生与被转诊至医院进行检查之间间隔了数周。未发现延误与社会阶层、年龄、身体隔离状况或患者的定期就诊率之间存在关联。有证据表明,一些胃肠道癌症患者在诊断前12个月内的就诊率因出现非胃肠道特异性症状而有所增加。如果全科医生要能够从那些患有非危及生命疾病和癌症病变均常见症状的患者中识别出早期癌症可能性高的患者,就需要对这些癌症的早期症状有更多了解。