Gondos A, Brenner H, Wabinga H, Parkin D M
Department of Epidemiology, German Centre for Research on Ageing, Berghiemer Str. 20, 69115 Heidelberg, Germany.
Br J Cancer. 2005 May 9;92(9):1808-12. doi: 10.1038/sj.bjc.6602540.
Epidemiological data on the occurrence of cancer in sub-Saharan Africa are sparse, and population-based cancer survival data are even more difficult to obtain due to various logistic difficulties. The population-based Cancer Registry of Kampala, Uganda, has followed up the vital status of all registered cancer patients with one of the 14 most common forms of cancer, who were diagnosed and registered between 1993 and 1997 in the study area. We report 5-year absolute and relative survival estimates of the Ugandan patients and compare them with those of black American patients diagnosed in the same years and included in the SEER Program of the United States. In general, the prognosis of cancer patients in Uganda was very poor. Differences in survival between the two patient populations were particularly dramatic for those cancer types for which early diagnosis and effective treatment is possible. For example, 5-year relative survival was as low as 8.3% for colorectal cancer and 17.7% for cervical cancer in Uganda, compared with 54.2 and 63.9%, respectively, for black American patients. The collection of good-quality follow-up data was possible in the African environment. The very poor prognosis of Ugandan patients is most likely explained by the lack of access to early diagnosis and treatment options in the country. On the policy level, the results underscore the importance of the consistent application of the national cancer control programme guidelines as outlined by the World Health Organization.
撒哈拉以南非洲地区癌症发病情况的流行病学数据匮乏，由于各种后勤困难，基于人群的癌症生存数据更难获取。乌干达坎帕拉基于人群的癌症登记处对所有登记在册的14种最常见癌症类型之一的癌症患者的生命状态进行了随访，这些患者于1993年至1997年在研究区域被诊断和登记。我们报告了乌干达患者的5年绝对和相对生存估计值，并将其与同年在美国监测、流行病学和最终结果（SEER）计划中登记的美国黑人患者的生存估计值进行比较。总体而言，乌干达癌症患者的预后非常差。对于那些有可能进行早期诊断和有效治疗的癌症类型，这两个患者群体的生存差异尤为显著。例如，乌干达结直肠癌的5年相对生存率低至8.3%，宫颈癌为17.7%，而美国黑人患者的这一比例分别为54.2%和63.9%。在非洲环境中收集高质量的随访数据是可行的。乌干达患者预后极差很可能是由于该国缺乏早期诊断和治疗选择。在政策层面，这些结果强调了一致应用世界卫生组织概述的国家癌症控制计划指南的重要性。
