Centre for Population Health Sciences and Global Health Academy, The University of Edinburgh Medical School, Edinburgh, Scotland, UK.
J Glob Health. 2012 Dec;2(2):020404. doi: 10.7189/jogh.02.020204.
Nearly two-thirds of annual mortality worldwide is attributable to non-communicable diseases (NCDs), with 70% estimated to occur in low- and middle-income countries (LMIC). Colorectal cancer (CRC) accounts for over 600 000 deaths annually, but data concerning cancer rates in LMIC is very poor. This study analyses the data available to produce an estimate of the incidence of colorectal cancer in Sub-Saharan Africa (SSA).
DATA FOR THIS ANALYSIS CAME FROM TWO MAIN SOURCES: a systematic search of Medline, EMBASE and Global Health which found 15 published data sets, and an additional 42 unpublished data sets which were sourced from the IARC and individual cancer registries. Data for case rates by age and sex, as well as population denominators were extracted and analysed to produce an estimate of incidence.
The crude incidence of CRC in SSA for both sexes was found to be 4.04 per 100 000 population (4.38 for men and 3.69 for women). Incidence increased with age with the highest rates in Southern Africa, particularly in South Africa. The rates of CRC in SSA were much lower than those reported for high-income countries.
Few health services in SSA are equipped to provide timely diagnosis and treatment of cancer in SSA. In addition, data collection systems are weak, meaning that the available statistics may underestimate the burden of disease. In order to improve health care services it is vital that accurate measurements of disease burden are available to policy makers.
全球近三分之二的年死亡率归因于非传染性疾病（NCDs），估计有 70%发生在低收入和中等收入国家（LMIC）。结直肠癌（CRC）每年导致超过 600000 人死亡，但有关 LMIC 癌症发病率的数据非常有限。本研究分析了现有数据，以估计撒哈拉以南非洲（SSA）结直肠癌的发病率。
本分析的数据来自两个主要来源：对 Medline、EMBASE 和 Global Health 的系统搜索发现了 15 个已发表的数据集，以及另外 42 个来自 IARC 和个别癌症登记处的未发表数据集。提取并分析了年龄和性别病例率以及人口分母的数据，以估计发病率。
发现男女两性结直肠癌的粗发病率在 SSA 为每 100000 人 4.04 例（男性为 4.38 例，女性为 3.69 例）。发病率随年龄增长而增加，南部非洲，特别是南非的发病率最高。SSA 的 CRC 发病率远低于高收入国家报告的发病率。
SSA 的卫生服务机构很少有能力及时诊断和治疗 SSA 的癌症。此外，数据收集系统薄弱，这意味着现有统计数据可能低估了疾病负担。为了改善医疗保健服务，政策制定者必须获得准确的疾病负担衡量标准。
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