Kamangar Farin, Dores Graça M, Anderson William F
Nutritional Epidemiology and Biostatistics Branches, Division of Cancer Epidemiology and Genetics, National Institutes of Health, Department of Health and Human Services, Rockville, MD 20852-7244, USA.
J Clin Oncol. 2006 May 10;24(14):2137-50. doi: 10.1200/JCO.2005.05.2308.
Efforts to reduce global cancer disparities begin with an understanding of geographic patterns in cancer incidence, mortality, and prevalence. Using the GLOBOCAN (2002) and Cancer Incidence in Five Continents databases, we describe overall cancer incidence, mortality, and prevalence, age-adjusted temporal trends, and age-specific incidence patterns in selected geographic regions of the world. For the eight most common malignancies-cancers of lung, breast, colon and rectum, stomach, prostate, liver, cervix, and esophagus-the most important risk factors, cancer prevention and control measures are briefly reviewed. In 2002, an estimated 11 million new cancer cases and 7 million cancer deaths were reported worldwide; nearly 25 million persons were living with cancer. Among the eight most common cancers, global disparities in cancer incidence, mortality, and prevalence are evident, likely due to complex interactions of nonmodifiable (ie, genetic susceptibility and aging) and modifiable risk factors (ie, tobacco, infectious agents, diet, and physical activity). Indeed, when risk factors among populations are intertwined with differences in individual behaviors, cultural beliefs and practices, socioeconomic conditions, and health care systems, global cancer disparities are inevitable. For the eight most common cancers, priorities for reducing cancer disparities are discussed.
减少全球癌症差异的努力始于对癌症发病率、死亡率和患病率的地理模式的了解。利用全球癌症发病率、死亡率和患病率数据库(GLOBOCAN,2002年)以及《五大洲癌症发病率》数据库,我们描述了世界选定地理区域的总体癌症发病率、死亡率和患病率、年龄调整后的时间趋势以及特定年龄组的发病率模式。对于八种最常见的恶性肿瘤——肺癌、乳腺癌、结肠直肠癌、胃癌、前列腺癌、肝癌、宫颈癌和食管癌——我们简要回顾了最重要的危险因素、癌症预防和控制措施。2002年,全球报告的新癌症病例估计有1100万,癌症死亡700万;近2500万人患有癌症。在八种最常见的癌症中,癌症发病率、死亡率和患病率的全球差异明显,这可能是由于不可改变的因素(即遗传易感性和衰老)和可改变的危险因素(即烟草、传染因子、饮食和身体活动)之间复杂的相互作用所致。事实上,当人群中的危险因素与个体行为、文化信仰和习俗、社会经济状况以及医疗保健系统的差异交织在一起时,全球癌症差异就不可避免。本文讨论了八种最常见癌症在减少癌症差异方面的优先事项。