COLORECTAL-CARCINOMA - DO ELDERLY PATIENTS PRESENT DIFFERENTLY
COLORECTAL-CARCINOMA - DO ELDERLY PATIENTS PRESENT DIFFERENTLY
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DOI：
10.1093/ageing/23.2.102
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发表时间：
1994-03-01
期刊：
影响因子：
6.7
通讯作者：
JAMES, OFW
中科院分区：
文献类型：
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作者：
CURLESS, R;FRENCH, JM;JAMES, OFW
前瞻性研究纳入了一组组织学诊断为结直肠癌的患者。所有受试者均由一名观察员使用结构化问卷进行访谈。150名‘年轻人’(70岁以下)和123名‘老年人’(70岁或以上)组成了研究样本。老年患者并不比年轻人更频繁地出现在急诊状态，但更多地被转到内科或老年科，而不是外科(P<；0.01)。从症状开始到组织学诊断的中位总延迟在两个年龄组(每个年龄组19.5周)之间没有差异。在老年受试者中，症状性贫血和非特异性症状更常见(p<；0.05)。在直接提问方面，结肠癌患者的症状报告在年龄组方面没有差异。对于直肠癌，以下症状在青年组中更为常见：下垂(优势比4.2；95%可信区间2.0~10.0)、腹痛或直肠疼痛(4.0；1.9~10.6)、肛门排气改变(2.6；1.3~5.8)、直肠粘液排出(2.2；1.1~4.8)。厌食症在老年患者中更为常见(0.4；0.1-0.8)。这项研究表明，直肠癌的症状表现在老年人中是不同的，但不一定会导致诊断的更大延误或非选择性表现的更高比率。
A cohort of patients with a histological diagnosis of colorectal carcinoma was enrolled prospectively. All subjects were interviewed by one observer using a structured questionnaire. One hundred and fifty 'young' (under 70 years) and 123 'elderly' (70 years or more) subjects formed the study sample. The elderly patients did not present more frequently as emergencies than the young, but were more often referred to medical or geriatric rather than surgical units (p < 0.01). There was no difference in median overall delay from symptom onset to histological diagnosis between the age groups (19.5 weeks in each). Symptomatic anaemia and nonspecific symptoms were more often the presenting complaint in the elderly subjects (p < 0.05). On direct questioning, there were no differences in symptom reporting with respect to age group for subjects with colonic cancer. For rectal cancer the following symptoms were more common in the young group: tenesmus (odds ratio 4.2; 95% confidence intervals 2.0-10.0), abdominal or rectal pain (4.0; 1.9-10.6), change in flatus production (2.6; 1.3-5.8), passage of mucus per rectum (2.2; 1.1-4.8). Anorexia was more common in the elderly patients (0.4; 0.1-0.8).This study suggests that symptomatic presentation of rectal cancer is different in the elderly but does not necessarily lead to greater delays in diagnosis nor higher rates of non-elective presentation.