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Reduction of the incidence and mortality of rectal cancer bypolypectomy:a prospective cohort study in Haining County

查看全文 作　　者：Shu Zheng Xi-Yong Liu Qi Dong,Cancer Institute,Zhejiang University,88 Jiefang Road,HangZhou 310009,Zhejiang Province,China Ke-feng Ding Lin-Bo Wang Pei-Lin Qiu Su-Zhan Zhang,The 2~(nd)affiliated Hospital,Medical School of Zhejiang University,88 Jiefang Road,HangZhou 310009,Zhejiang Province,China Xin-Feng Ding Yong-Zhou Shen Gao-Fei Shen Oi-Rong Sun Wei-Dong Li,Haining Cancer Institute,Haining 314400,Zhejiang Province,China 高影响力作者 出　　处：《World Journal of Gastroenterology》索引2002年第8卷第3期,共5页高影响力期刊 基　　金：The 7~(th) 5-year Nation'a] Medical Strategic Science and Technology Plan,No.75-61-02-17;The 8~(th) 5-year National Medical Strategic Science and Technology Plan,No.85-914-01-09 摘　　要：AIM: To reduce the incidence and morlality of rectal cancerand address the hypothesis that colorectal cancer often arisefrom precursor lesion (s), either adenomas or non-alenomatous polyps, by conducting a population-basedmass screening for colorectal cancer in Haining County,Zhejiang, PRCMETHODS: From 1977 to 1980, physicians screened thepopulation of Haining County using 15 cm rigid endoscopy.Of over 240 000 participants, 4076 of them were diagnoselwith Precursor Iesions, eitler alenomas or non-adenomatous polyps, which were then removedl surgically.All individuals with precursor lesionswere followed up andreexamined by endoscopy every two to five years upto 1998.RESULTS: After the initial screening, 953 metactronousadenomas and 417 non-adenomatous polyps ware detected andremoved from the members of this cohort. Further, 27 cases ofcolorectal cancer were detected and treated. Log-rank tuestsshowed that the survival time among those cancer patients whounderwent mass screening increased significantly comparedtothat of other colorectal cancer patients (P < 0.0001). Accordingto the population-based cancer registry in Haining County,age-adjusted incidence and mortality of rectal cancer decreasedby 41% and 29 % from 1977-1981 to 1992-1996, respectively.Observed cumulative 20-year rectal cancer incidence was 31%lower than the expected in the screened group; the mortalitydue to rectal cancer was 18 % lower thah the expected in thescreened group.CONCLUSION: Mass screening for rectal cancer andprecursor lesions with protocoscopy in the generalpopulation and periodical following-up with routineendoscopy for high-risk patients may decrease both theincidence and mortality of rectal cancer. 关 键 词：息肉切除 直肠癌 发病率 死亡率
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