McMichael A J, Giles G G
Department of Community Medicine, University of Adelaide, South Australia.
Cancer Surv. 1994;19-20:77-98.
International trends in the incidence, mortality and survival for colorectal cancers are heterogeneous, probably because of interpopulation diversity in trends in risk factors and in systems of medical care and screening programmes. Broadly, colorectal cancer rates correlate with the adoption of a western lifestyle, and, depending on each country's stage of transition, colorectal cancer incidence can be increasing (often rapidly), levelling or declining. In high risk countries, although decreases in incidence might be expected in the longer term in response to current dietary trends, some short term increases in incidence may result from the promotion of screening activities. The growing proportion of early stage tumours detected in screened populations will eventually be reflected in lower mortality rates.
结直肠癌发病率、死亡率及生存率的国际趋势存在差异,这可能是由于不同人群在风险因素、医疗保健体系及筛查项目等方面的趋势存在差异。总体而言,结直肠癌发病率与西方生活方式的采用相关,并且,根据每个国家的转型阶段,结直肠癌发病率可能正在上升(通常迅速)、趋于平稳或下降。在高风险国家,尽管从长期来看,鉴于当前的饮食趋势,发病率可能会下降,但筛查活动的推广可能会导致短期内发病率有所上升。在接受筛查的人群中,早期肿瘤检出比例的增加最终将反映在较低的死亡率上。