diagnosis and treatment of patients with colon cancer optimization based on analysis of the 12 -year period
Science Articles / / August 12, 2017
A. Frolov, MV ShaydorovCity Clinical Hospital №5 «MedVAZ" Tolyatti
Against the background of the achievements of modern cancer treatment colon cancer remains a major unsolved clinical problem.In general the structure of morbidity in the Russian Federation noted the constant steady upward trend in the incidence of this disease.In the city of Togliatti in the past 10 years, this figure has increased by more than 2-fold, from 77 cases in 1990 to 158 in 2002. Figure 1 shows the number of patients taken to register a first-ever diagnosis of "cancer of the colon"(C-1 of 8) from 1990 to 2002.
Figure 1. take account of patients with first-ever diagnosis of "colon cancer" (August 1 st) from 1990 to 2002.
leading role in the treatment of colon cancer takes a surgical method.The search continues for new methods of surgical treatment of colon cancer.The used equipment operations, pre- and postoperative management have greatly expand the contingent of patients operated with minimal post-operative complic
reasons diagnosis in stages III and IV are many, among them the late referral of patients for help related to the small number of complaints in the beginning of the disease, a low level of suspicion of cancer in the population.In this case, as practice shows, the role of active detection of colon diseases during the medical examination is extremely low.The result of the analysis of the effectiveness of medical examination, carried out by us in the 12 year period from 1990 to 2002 showed that in the course of carrying out an average of detected only 1.7% of the total number of patients taken to register the first-ever diagnosis of colon cancer (reachingg.- maximum at 7.2% in 1995).In addition, a key element in the timely diagnosis is the effective work of primary care: a doctor - the first contact with patients.№2 The graph shows the results of 12-year period, reflecting the percentage of the later stages of the disease, identified during the initial diagnosis.
Diagram №2.The structure of morbidity in stages in patients with first-ever diagnosis of "colon cancer" (C-18) for the period from 1990 to 2002.
As can be seen from the above chart, the percentage of patients identified during the initial diagnosis in the III and IV stages of the disease, decreased from 66.17% in 1990 to 33.78% in 2002. Since 1997, there has been an annualreducing the number of running instances.The increase in the proportion of patients identified in the early stages of the disease, was associated both with increased outreach (including active media use), as well as measures aimed at improving the efficiency of outpatient care (including a detailed clinical examination of all running cases with mandatory participation in the analysisoncologist and control by the oncology service for measures to prevent them.
the same time holding the combined treatment of colon cancer patients has significantly increased 5-year survival rate. a common indicator of the effectiveness of the treatment in addition to the three- and five-year survival rate is the growth chart displaying their dispensary.
Figure 3. Number of registered patients with colon cancer (C-18) from the time of diagnosis, and more than 5 years.
As seen from the chart, based on the results of our study showed an increase by 3.6 times the amount ofpatients who are registered with the time of diagnosis, and more than 5 years, for the period from 1990 to 2002. This, in our view, was associated with an earlier diagnosis by increasing the efficiency of primary health care, an increase in the level of oncology knowledge among the populationand the introduction of combined treatment of colon cancer.
Another conclusion arising in the course of this study is the fact that the conduct of professional examinations in their present form does not solve the problem of diagnosis of cancer of the colon in the early stages.Search and introduction of new methods of screening is currently the most urgent task for the early detection and management of patients.