Robinson M H, Thomas W M, Hardcastle J D, Chamberlain J, Mangham C M
Department of Surgery, University Hospital, Queen's Medical Centre, Nottingham, UK.
Br J Surg. 1993 Dec;80(12):1610-2. doi: 10.1002/bjs.1800801241.
A study was carried out to investigate the change in stage at presentation of patients with colorectal cancer over 10 years. Cases were identified from the control group of subjects enrolled into a randomized controlled study based on Haemoccult screening for colorectal neoplasia. Of 405 subjects in the control group (presenting with symptomatic colorectal cancer, 206 presented before 1989 and 199 since then. The number of patients with Dukes' stage A carcinoma diagnosed since 1989 rose from 21 (10.4 per cent) to 35 (18.1 per cent); this change occurred for rectosigmoid tumours (9.9 per cent before 1989, 28 per cent after 1989) but not for colonic cancer (10.9 per cent before 1989, 11.5 per cent thereafter). An increase in the proportion of patients with symptomatic early-stage rectosigmoid cancer has been observed in the past 10 years. No such change occurred in those with colonic cancer. This may reflect a change in awareness of te disease and its symptoms by patients and general practitioners.
一项研究旨在调查10年间结直肠癌患者确诊时分期的变化。病例来自一项基于潜血筛查结直肠肿瘤的随机对照研究的对照组。对照组的405名受试者（均患有症状性结直肠癌）中，206人在1989年之前确诊，199人此后确诊。1989年以后诊断出的杜克A期癌患者数量从21例（10.4%）增至35例（18.1%）；这种变化出现在直肠乙状结肠肿瘤患者中（1989年之前为9.9%，1989年之后为28%），而结肠癌患者中未出现这种变化（1989年之前为10.9%，此后为11.5%）。过去10年中，有症状的早期直肠乙状结肠癌患者比例有所增加。结肠癌患者未出现此类变化。这可能反映出患者和全科医生对该病及其症状的认知发生了变化。
