Læknablaðið - 01.08.1968, Blaðsíða 38

166
LÆKNABLAÐIÐ
fyrst og fremst fyrir atbeina starfandi lækna utan sjúkrahúsa,
en það eru þeir, sem fyrst sjá sjúklinginn. Því má ekki gleyma,
að fyrsta læknisvitjun sjúklings með þennan sjúkdóm er sú
mikilvægasta.
SUMMARY
The incidence of gastric cancer in Icelanders is very high wheras the
incidence of colon and rectum cancer is relatively low. The distribution of
cancer within the digestive tract of the Icelandic population differs mark-
edly from that of populations in neighbouring countries.
During the 14 year period, 1952—1965, 725 patients with cancer in the
digestive tract were treated in the Surgical Dept. of theUniversity Hospital
(Landspítalinn). In 488 of these cases the lesion was located in the
stomach, in 102 in the esophagus and 135 had colon or rectum cancer.
78 patients had cancer in the colon. The most common initial symptom
in this group was abdominal pain but in the cancer recti group of 53
patients the most common initial symptom was change in bowel habits.
On the whole, the three most dominating symptoms in the cancer coli
group were change in bowel habits in 82%, abdominal pain in 72%, gen-
eral weakness with or without loss of weight in 52% of the cases. In the
cancer recti group the case history stated change of bowel habits in 91%
of the cases.
36 of the 135 patients with cancer in the large bowel were admitted
to the surgical department because of acute illness — obstruction or per-
foration.
57% of the cases came to the surgical department within less than
six months from the onset of symptoms but in 30% the duration of symp-
toms was from one to three years before admission.
47 patients or 36% consulted a doctor in the first month after onset
of symptoms, 28 of these were admitted for treatment before the end of
the second month. In 17 cases, however, the admission was delayed for
one to twelve months and in two cases for more than a year. In a few
of these cases it was not possible to discern the reason for the delay in
admission. Some were delayed because of normal diagnostic difficulties
but in the majority of them the doctor was to blame for the delay.
129 of the 135 patients underwent some type of surgical intervention.
In 10 cases abdominal exploration only, in 22 cases colostomy or entero-
enterostomy, in 11 cases palliative resection and in 88 cases surgery for
eure. Primary mortality in the whole group was 10% but in the radically
treated group 7%.
Five year survival rate of the radically treated was 48%.