31-初级保健中新发直肠出血患者结直肠癌的患病风险：一项10年的前瞻性研究.pdf
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Hoyland House,Painswic k,Glouces tershire
GL6 6RD,Jenni fer du Toi t,general pr acti tioner,Ke vin Barra clough,general pr acti tioner
Ac ademic Uni t of
Primary Hea lth Ca re,De partment of
Community
Based Medic ine,Univers ity of Bristol ,Bris tol BS8 1AU
Wi ll iam Hami lton,senior resea rch fellow
Correspondence to:
J du Toi t
kba rraclough @
ehotspot . co. uk
analys is of a me la noma epidemic . Int J Ca ncer 1993; 55 : 765 -70 .
10 Swe rlick RA, Che n S. The melanoma e pidemic . Is incr eased surve il la nce the
solut ion or the problem? Arch Derma tol 1996; 132: 881-4.
11 Surveil la nce resea r ch progr am . Nat iona l Cance r Ins t itute SEER * Sta t softwar e,vers ion 5. 3. 0. www. se er. c ance r. gov/ see rs tat ( acc es se d 31 Aug 2004) .
12 Sone S, Ta kashima S, Li F , Yang Z, Honda T, Mar uyama Y, e t a l . Mas s
sc reening for lung cance r wi th mobi le spir al computed tomography sca nne r.
La ncet 1998; 351 : 1242 -5 .
13 Zahl P H, St rand BH, Mae hle n J . Incidence of brea st c ancer in Norway and
Swe den during int roduc tion of na tionwide sc reening: prospect ive cohort s tudy.
BMJ 2004 ; 328: 921-4.
14 Spouge AR , Wi lson SR , Wooley B. Abdomina l sonogr aphy in asymptomat ic
exec utive s : pre valence of pathologic findings , pote nt ial benefits , and
pr oblems . J Ult ra sound Med 1996; 15 : 763 -7 .
15 Woods WG, Gao R N, Shuster J J , Robison LL, Be rnstein M, Wei tzma n S, et
al . Scre ening of infants and mortal i ty due to ne uroblas toma. N Engl J Med
2002; 346 : 1041-6 .
16 Sc hi l ling FH , Spix C, Be rthold F , Ert tm ann R , Fehse N, Hero B , et al .
Neurobla stoma scre ening a t one ye ar of a ge. N Engl J Med 2002 ; 346 : 1047 -
53.
17 Eskew LA, Ba re RL, McCul lough DL. Sys tem at ic 5 re gion pros ta te biopsy is
super ior to sextant method for diagnos ing ca rcinoma of the pros ta te . J Urol
1997; 157 : 199-202.
18 Ba baia n R J , Toi A, Kamoi K, Tr oncoso P, Swee t J , Eva ns R, e t a l . A
compar at ive a na lysis of sextant and a n e xtended 11- cor e mult isi te dire cted
biopsy s tra te gy. J Ur ol 2000 ; 163: 152-7.
19 Arnold PM, Niemann TH, Ba hnson RR . Exte nded sec tor biopsy for detect ion
of ca rcinoma of the pros tate. Urol Oncol 2001; 6 : 91-3.
20 Durkan GC, She ikh N, Johnson P , Hi ldre th AJ , Gre ene DR . Improving
pr os ta te ca ncer detect ion wi th a n exte nde d-c ore t rans rec ta l ult ra sonogra phy-
guide d pros tate biopsy protoc ol . Br J Ur ol Int 2002 ; 89 : 33 -9 .
21 F le shne r N, Klotz L. R ole of " saturat ion biopsy" in the detect ion of pros tate
cance r among diffic ul t diagnost ic cases . Urology 2002 ; 60 : 93 -7 .
BMJ 2005; 331 : 481
初级保健中新发直肠出血患者结直肠癌的患病风险:
一项 10 年的前瞻性研究
Risk in primary care of colorectal cancer f rom new onset rectal bleeding:
10 year prospective study
Jennifer du Toit, William Hamilton, Kev in Barraclough
摘要
目的:监测初级保健机构中新发直肠出血患
者的结直肠癌和腺瘤的患病风险。
设计:队列研究。
地点:英国的一所乡村全科诊所。
研究对象:年龄≥45 岁、 新发直肠出血患者,无论是否伴有其他症状。
主要研究终点指标: 研究对象行肠道检查
后, 发现结肠癌或结肠腺瘤的百分比。
结果: 在这项为期 10 年的研究中, 有 265 例
新发直肠出血患者, 其中 15 例( 5. 7% , 95% CI :
3. 2% ～ 9. 2% ) 有结直肠癌, 13 例( 4. 9% , 2. 6% -
8. 4% ) 有结肠腺瘤。仅有 2 例癌症患者曾出现
过腹泻。
结论:年龄大于等于45 岁的新发直肠出血患
者中十分之一有结肠肿瘤, 因此对所有此类患者
都应进行肠道检查,无论是否伴随其他症状 ......
Hoyland House,Painswic k,Glouces tershire
GL6 6RD,Jenni fer du Toi t,general pr acti tioner,Ke vin Barra clough,general pr acti tioner
Ac ademic Uni t of
Primary Hea lth Ca re,De partment of
Community
Based Medic ine,Univers ity of Bristol ,Bris tol BS8 1AU
Wi ll iam Hami lton,senior resea rch fellow
Correspondence to:
J du Toi t
kba rraclough @
ehotspot . co. uk
analys is of a me la noma epidemic . Int J Ca ncer 1993; 55 : 765 -70 .
10 Swe rlick RA, Che n S. The melanoma e pidemic . Is incr eased surve il la nce the
solut ion or the problem? Arch Derma tol 1996; 132: 881-4.
11 Surveil la nce resea r ch progr am . Nat iona l Cance r Ins t itute SEER * Sta t softwar e,vers ion 5. 3. 0. www. se er. c ance r. gov/ see rs tat ( acc es se d 31 Aug 2004) .
12 Sone S, Ta kashima S, Li F , Yang Z, Honda T, Mar uyama Y, e t a l . Mas s
sc reening for lung cance r wi th mobi le spir al computed tomography sca nne r.
La ncet 1998; 351 : 1242 -5 .
13 Zahl P H, St rand BH, Mae hle n J . Incidence of brea st c ancer in Norway and
Swe den during int roduc tion of na tionwide sc reening: prospect ive cohort s tudy.
BMJ 2004 ; 328: 921-4.
14 Spouge AR , Wi lson SR , Wooley B. Abdomina l sonogr aphy in asymptomat ic
exec utive s : pre valence of pathologic findings , pote nt ial benefits , and
pr oblems . J Ult ra sound Med 1996; 15 : 763 -7 .
15 Woods WG, Gao R N, Shuster J J , Robison LL, Be rnstein M, Wei tzma n S, et
al . Scre ening of infants and mortal i ty due to ne uroblas toma. N Engl J Med
2002; 346 : 1041-6 .
16 Sc hi l ling FH , Spix C, Be rthold F , Ert tm ann R , Fehse N, Hero B , et al .
Neurobla stoma scre ening a t one ye ar of a ge. N Engl J Med 2002 ; 346 : 1047 -
53.
17 Eskew LA, Ba re RL, McCul lough DL. Sys tem at ic 5 re gion pros ta te biopsy is
super ior to sextant method for diagnos ing ca rcinoma of the pros ta te . J Urol
1997; 157 : 199-202.
18 Ba baia n R J , Toi A, Kamoi K, Tr oncoso P, Swee t J , Eva ns R, e t a l . A
compar at ive a na lysis of sextant and a n e xtended 11- cor e mult isi te dire cted
biopsy s tra te gy. J Ur ol 2000 ; 163: 152-7.
19 Arnold PM, Niemann TH, Ba hnson RR . Exte nded sec tor biopsy for detect ion
of ca rcinoma of the pros tate. Urol Oncol 2001; 6 : 91-3.
20 Durkan GC, She ikh N, Johnson P , Hi ldre th AJ , Gre ene DR . Improving
pr os ta te ca ncer detect ion wi th a n exte nde d-c ore t rans rec ta l ult ra sonogra phy-
guide d pros tate biopsy protoc ol . Br J Ur ol Int 2002 ; 89 : 33 -9 .
21 F le shne r N, Klotz L. R ole of " saturat ion biopsy" in the detect ion of pros tate
cance r among diffic ul t diagnost ic cases . Urology 2002 ; 60 : 93 -7 .
BMJ 2005; 331 : 481
初级保健中新发直肠出血患者结直肠癌的患病风险:
一项 10 年的前瞻性研究
Risk in primary care of colorectal cancer f rom new onset rectal bleeding:
10 year prospective study
Jennifer du Toit, William Hamilton, Kev in Barraclough
摘要
目的:监测初级保健机构中新发直肠出血患
者的结直肠癌和腺瘤的患病风险。
设计:队列研究。
地点:英国的一所乡村全科诊所。
研究对象:年龄≥45 岁、 新发直肠出血患者,无论是否伴有其他症状。
主要研究终点指标: 研究对象行肠道检查
后, 发现结肠癌或结肠腺瘤的百分比。
结果: 在这项为期 10 年的研究中, 有 265 例
新发直肠出血患者, 其中 15 例( 5. 7% , 95% CI :
3. 2% ～ 9. 2% ) 有结直肠癌, 13 例( 4. 9% , 2. 6% -
8. 4% ) 有结肠腺瘤。仅有 2 例癌症患者曾出现
过腹泻。
结论:年龄大于等于45 岁的新发直肠出血患
者中十分之一有结肠肿瘤, 因此对所有此类患者
都应进行肠道检查,无论是否伴随其他症状 ......
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