Evans J T, Vana J, Aronoff B L, Baker H W, Murphy G P
Ann Surg. 1978 Dec;188(6):716-20. doi: 10.1097/00000658-197812000-00002.
Survey results of long- and short-term outcome audits of colon cancer in participating hospitals with cancer programs conducted during 1976-7 by the American College of Surgeons are presented. In the long-term audit of 38,621 cases reported by 327 hospitals in 46 states, the overall percentage of cases in localized stage (29.3%) is significantly lower than in the recent series from the National Cancer Institute. The observed survival was substantially lower than the survival rates published in recent smaller series; however, survival approaches the end results for the period 1967-1973. In the short-term audit, the analysis of 11,655 cases diagnosed in 1976 and reported by 491 hospitals from fifty states showed that while 41% of patients had symptoms for less than a month, only 29.5% were diagnosed in the localized stage. Surgery was the predominant treatment modality with an overall resectable rate of 83%. No difference was observed in the stage at diagnosis when the short-term audit (1976) was compared with that found in the long-term audit (1971). The results suggest that the early diagnosis of symptomatic patients may not always substantially improve the cure and survival rate. The screening of asymptomatic patients is suggested as the more promising approach to the substantial improvement of presently less than ideal end results.
本文呈现了美国外科医师学会于1976 - 1977年期间，对参与癌症项目的医院中结肠癌的长期和短期结局审计的调查结果。在对46个州327家医院报告的38,621例病例进行的长期审计中，局部阶段病例的总体百分比（29.3%）显著低于美国国立癌症研究所近期系列研究中的比例。观察到的生存率大幅低于近期较小系列研究中公布的生存率；然而，生存率接近1967 - 1973年期间的最终结果。在短期审计中，对1976年诊断并由五十个州的491家医院报告的11,655例病例进行分析，结果显示，虽然41%的患者症状持续时间不到一个月，但只有29.5%的患者被诊断为局部阶段。手术是主要的治疗方式，总体可切除率为83%。将短期审计（1976年）与长期审计（1971年）中发现的诊断阶段进行比较时，未观察到差异。结果表明，有症状患者的早期诊断可能并不总能显著提高治愈率和生存率。建议对无症状患者进行筛查，作为大幅改善目前不太理想的最终结果的更有前景的方法。
