癌症在非洲、亚洲和中美洲的生存情况：基于人群的研究。

Cancer survival in Africa, Asia, and Central America: a population-based study.

机构信息

Screening Group, International Agency for Research on Cancer, Lyon, France.

出版信息

Lancet Oncol. 2010 Feb;11(2):165-73. doi: 10.1016/S1470-2045(09)70335-3. Epub 2009 Dec 10.

DOI:10.1016/S1470-2045(09)70335-3

PMID:20005175

Abstract

BACKGROUND

Population-based cancer survival data, a key indicator for monitoring progress against cancer, are not widely available from countries in Africa, Asia, and Central America. The aim of this study is to describe and discuss cancer survival in these regions.

METHODS

Survival analysis was done for 341 658 patients diagnosed with various cancers from 1990 to 2001 and followed up to 2003, from 25 population-based cancer registries in 12 countries in sub-Saharan Africa (The Gambia, Uganda), Central America (Costa Rica), and Asia (China, India, Pakistan, Philippines, Saudi Arabia, Singapore, South Korea, Thailand, Turkey). 5-year age-standardised relative survival (ASRS) and observed survival by clinical extent of disease were determined.

FINDINGS

For cancers in which prognosis depends on stage at diagnosis, survival was highest in China, South Korea, Singapore, and Turkey and lowest in Uganda and The Gambia. 5-year ASRS ranged from 76-82% for breast cancer, 63-79% for cervical cancer, 71-78% for bladder cancer, and 44-60% for large-bowel cancers in China, Singapore, South Korea, and Turkey. Survival did not exceed 22% for any cancer site in The Gambia; in Uganda, survival did not exceed 13% for any cancer site except breast (46%). Variations in survival correlated with early detection initiatives and level of development of health services.

INTERPRETATION

The wide variation in cancer survival between regions emphasises the need for urgent investments in improving awareness, population-based cancer registration, early detection programmes, health-services infrastructure, and human resources.

FUNDING

Association for International Cancer Research (AICR; St Andrews, UK), Association pour la Recherche sur le Cancer (ARC, Villejuif, France), and the Bill & Melinda Gates Foundation (Seattle, USA).

摘要

背景

人口癌症生存数据是监测癌症防治进展的关键指标，但在非洲、亚洲和中美洲的许多国家并不广泛。本研究旨在描述和讨论这些地区的癌症生存情况。

方法

对来自撒哈拉以南非洲地区（冈比亚、乌干达）、中美洲（哥斯达黎加）和亚洲（中国、印度、巴基斯坦、菲律宾、沙特阿拉伯、新加坡、韩国、泰国、土耳其）的 12 个国家的 25 个基于人群的癌症登记处的 341658 例于 1990 年至 2001 年诊断出的各种癌症患者进行生存分析，并随访至 2003 年。确定了 5 年年龄标准化相对生存率（ASRS）和按临床疾病范围观察到的生存率。

结果

对于预后取决于诊断时分期的癌症，生存率最高的国家是中国、韩国、新加坡和土耳其，最低的是乌干达和冈比亚。乳腺癌的 5 年 ASRS 范围为 76%-82%，宫颈癌为 63%-79%，膀胱癌为 71%-78%，结直肠癌为 44%-60%，中国、新加坡、韩国和土耳其。在冈比亚，任何癌症部位的生存率都不超过 22%；在乌干达，除乳腺癌（46%）外，任何癌症部位的生存率都不超过 13%。生存率的差异与早期发现举措和卫生服务发展水平相关。