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在低收入和中等收入国家实施癌症控制基本干预措施组合的成本、可负担性和可行性:《疾病控制优先事项》第三版的主要内容。

Costs, affordability, and feasibility of an essential package of cancer control interventions in low-income and middle-income countries: key messages from Disease Control Priorities, 3rd edition.

机构信息

Center for Disease Dynamics, Economics & Policy, Washington, DC, USA.

International Agency for Research on Cancer, Lyon, France.

出版信息

Lancet. 2016 May 21;387(10033):2133-2144. doi: 10.1016/S0140-6736(15)00755-2. Epub 2015 Nov 11.

Abstract

Investments in cancer control--prevention, detection, diagnosis, surgery, other treatment, and palliative care--are increasingly needed in low-income and particularly in middle-income countries, where most of the world's cancer deaths occur without treatment or palliation. To help countries expand locally appropriate services, Cancer (the third volume of nine in Disease Control Priorities, 3rd edition) developed an essential package of potentially cost-effective measures for countries to consider and adapt. Interventions included in the package are: prevention of tobacco-related cancer and virus-related liver and cervical cancers; diagnosis and treatment of early breast cancer, cervical cancer, and selected childhood cancers; and widespread availability of palliative care, including opioids. These interventions would cost an additional US$20 billion per year worldwide, constituting 3% of total public spending on health in low-income and middle-income countries. With implementation of an appropriately tailored package, most countries could substantially reduce suffering and premature death from cancer before 2030, with even greater improvements in later decades.

摘要

癌症控制投资——预防、检测、诊断、手术、其他治疗和姑息治疗——在低收入国家,特别是在中低收入国家越来越需要,因为这些国家的大多数癌症死亡病例未经治疗或姑息治疗就发生了。为了帮助各国扩大当地适用的服务,《癌症》(九卷本《疾病控制优先事项》第三版中的第三卷)为各国制定了一套可能具有成本效益的基本措施供其考虑和调整。该方案中包括的干预措施有:预防与烟草相关的癌症和与病毒相关的肝癌和宫颈癌;诊断和治疗早期乳腺癌、宫颈癌和某些儿童癌症;广泛提供姑息治疗,包括阿片类药物。全世界每年将为此额外增加 2000 亿美元的支出,占低收入和中等收入国家公共卫生总支出的 3%。通过实施适当调整的一揽子计划,大多数国家可以在 2030 年前大幅减少癌症导致的痛苦和过早死亡,在以后的几十年里还会取得更大的改善。

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