PATH, PO Box 900922, Seattle, WA 98109, United States of America (USA).
Bull World Health Organ. 2013 Sep 1;91(9):683-90. doi: 10.2471/BLT.12.116020.
The health concerns of women in their mid-adult years - when the prime age of reproduction has passed - have been traditionally given little or no attention by health systems and donors, despite the heavy burden that diseases such as breast and cervical cancer impose on women and their families. The risk of sexually transmitted infections that accompanies sexual relations and the risk of death and morbidity associated with pregnancy have long been recognized and have stimulated major control efforts that are finally yielding positive results. Much less attention has been focused, however, on how experiences in early life can affect women's health in adulthood. Breast and cervical cancers kill more women than any other types of cancer in all parts of the developing world. In most of Asia and Latin America and some African countries, deaths from these two forms of cancer now outnumber pregnancy-related deaths. There are five compelling reasons for focusing on these cancers now to try to reverse these epidemiologic trends: (i) the burden of breast and cervical cancer is large and is growing; (ii) effective screening and treatment are available; (iii) research is generating new knowledge; (iv) there are opportunities for synergy with other health programmes; and (v) noncommunicable diseases are the focus of much current interest.
中年女性的健康问题——即生育高峰期过后的黄金年龄——一直以来都很少或根本没有受到卫生系统和捐助者的关注，尽管乳腺癌和宫颈癌等疾病给妇女及其家庭带来了沉重负担。性传播感染的风险伴随着性活动，与怀孕相关的死亡和发病风险也长期以来一直受到重视，并促使开展了重大控制工作，最终取得了积极成果。然而，人们对生命早期的经历如何影响成年期妇女的健康关注甚少。在发展中国家的所有地区，乳腺癌和宫颈癌导致的死亡人数多于任何其他类型的癌症。在亚洲大部分地区、拉丁美洲和一些非洲国家，死于这两种癌症的人数现在超过了与怀孕相关的死亡人数。现在有五个令人信服的理由需要关注这些癌症，以试图扭转这些流行病学趋势：(i)乳腺癌和宫颈癌的负担很大且不断增加；(ii)有效的筛查和治疗方法已经存在；(iii)研究正在产生新知识；(iv)与其他卫生方案存在协同增效的机会；以及 (v)非传染性疾病是当前的关注焦点。
