Divisions of Human Biology and Public Health Sciences, Fred Hutchinson Cancer Research Center, Department of Pathology, University of Washington, Seattle, WA 98109, USA.
Salud Publica Mex. 2009;51 Suppl 2:s141-6. doi: 10.1590/s0036-36342009000800003.
This review highlights the increasing incidence of breast cancer world-wide and the increasing burden of breast cancer deaths experienced by lower-income countries. The causes of increasing incidence have been attributed to changes in the prevalence of reproductive risk factors, lifestyle changes, and genetic and biological differences between ethnic and racial groups. All these factors may contribute, but data linking etiological factors to increased risk in developing countries is lacking. The challenge for lower-income countries is developing effective strategies to reverse the trend of increasing mortality. Down-staging of breast cancer by early detection is a promising long-term strategy for preventing disease-related deaths but it is difficult to make the economic investment required to carry out broad screening programs. Successful strategies for addressing the growing breast cancer burden will therefore take political will, reliable data, public and medical community awareness, and partnerships between community advocates, governments, non-governmental organizations and biotechnology.
这篇综述强调了全球范围内乳腺癌发病率的上升，以及低收入国家乳腺癌死亡人数的增加。发病率上升的原因可归因于生殖风险因素、生活方式改变以及种族和民族群体之间遗传和生物学差异的流行率变化。所有这些因素都可能起作用，但将病因因素与发展中国家的风险增加联系起来的数据还很缺乏。低收入国家面临的挑战是制定有效的策略来扭转死亡率上升的趋势。早期检测乳腺癌的降期是预防与疾病相关死亡的有前途的长期策略，但要进行广泛的筛查计划，就很难进行经济投资。因此，要成功应对日益增长的乳腺癌负担，需要有政治意愿、可靠的数据、公众和医疗界的认识，以及社区倡导者、政府、非政府组织和生物技术之间的伙伴关系。
