目的 从医疗模式转变的高度,分析国内大肠肿瘤早期诊断、筛查的现状以及与世界发达国家的差异.进一步论述大肠肿瘤伺机性筛查的必要性和可行性.方法 收集近35年来我国关于大肠肿瘤早期诊断、筛查的文献以及近年国外大肠肿瘤筛查指南,并进行比较分析.结果 1975-1990年、1991-2000年、2001-2010年各阶段我国关于大肠肿瘤、早期诊断、筛查的文献呈明显上升趋势,且现阶段我国的大肠肿瘤早期诊断及筛查方法学研究及进展与国外基本同步;包括美国在内的部分发达国家也提出伺机性筛查大肠肿瘤的模式.结论 伺机性筛查模式适合我国现行医疗制度特点和国情,也是"价值医学"模式的具体体现,因而更注重医疗行为对公众个体健康的价值.%Objective To analyze current situation of early diagnosis and screening of colorectal carcinoma in China as well as disparities from developed countries in the sight of medical model transition, and discuss the necessity and feasibility of opportunistic screening of colorectal carcinoma in China. Methods We reviewed Chinese literatures on early diagnosis and screening of colorectal carcinoma during recent 35 years and compared them with guidelines abroad. Results Number of literatures among 3 phases(1975-1990, 1991-2000. 2001-2010) were increased dramaticafly; moneover, researches and progression in these fields almost synchronized with foreign countries; some developed countries including the United States had put forward opportunistic screening pattern for colorectal carcinoma. Conclusions Opportunistic screening pattem of colorectal carcinoma is suitable for China with regard to current health care system and national conditions. furthermore, it is an embodiment of value-based medicine since it puts more emphasis on individual health.
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