Wakefield S E, Wheeler D W, Mortensen N J, Kettlewell M G
Department of Surgery, John Radcliffe Hospital, Oxford, UK.
Eur J Surg Oncol. 1998 Dec;24(6):525-7. doi: 10.1016/s0748-7983(98)93464-3.
Two previous studies (1966-1971 and 1979-1983) of patients with colorectal cancer (CRC) have been reported from our hospital. A large increase in the incidence of CRC was noted, and an improvement in Dukes' staging of tumours at treatment. We report a series of patients admitted with newly diagnosed CRC to evaluate this trend further.
A prospective study was made of all patients with newly diagnosed CRC admitted to the John Radcliffe Hospital, Oxford in 1995. Means of diagnosis and Dukes' staging were recorded.
In 1 year 177 patients were admitted with newly diagnosed CRC. Previous studies had shown an increase from 52.8 to 103.4 patients per year. The number of patients diagnosed by colonoscopy doubled from 19.4% in 1979-1983 to 41% in 1995. No significant change in the proportion of patients with Dukes' A or B tumours was found.
The number of patients treated annually with CRC in a stable population has more than trebled in the last 3 decades. A real increase in the incidence of CRC is likely as this rise cannot be explained solely by changing referral patterns or an ageing community. There are no significant changes in presentation patterns despite the availability of colonoscopy since 1975.
我院此前已报道过两项关于结直肠癌（CRC）患者的研究（1966 - 1971年和1979 - 1983年）。研究发现CRC的发病率大幅上升，且治疗时肿瘤的Dukes分期有所改善。我们报告了一系列新诊断为CRC的入院患者，以进一步评估这一趋势。
对1995年入住牛津约翰拉德克利夫医院的所有新诊断为CRC的患者进行了一项前瞻性研究。记录诊断方法和Dukes分期。
在1年时间里，有177例新诊断为CRC的患者入院。此前的研究显示，每年的患者人数从52.8例增加到了103.4例。通过结肠镜检查诊断出的患者数量从1979 - 1983年的19.4%增加了一倍，在1995年达到41%。Dukes A期或B期肿瘤患者的比例没有显著变化。
在过去30年里，稳定人群中每年接受CRC治疗的患者数量增加了两倍多。CRC发病率可能确实有所上升，因为这种增长不能仅通过转诊模式的改变或社区老龄化来解释。尽管自1975年以来就有结肠镜检查，但就诊模式没有显著变化。
