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欧盟28国以外的欧洲理事会国家的结直肠癌筛查

Colorectal cancer screening in countries of European Council outside of the EU-28.

作者信息

Altobelli Emma, D'Aloisio Francesco, Angeletti Paolo Matteo

机构信息

Emma Altobelli, Francesco D'Aloisio, Paolo Matteo Angeletti, Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy.

出版信息

World J Gastroenterol. 2016 May 28;22(20):4946-57. doi: 10.3748/wjg.v22.i20.4946.

Abstract

AIM

To provide an update on colorectal cancer (CRC) screening programmes in non-European Union (EU)-28 Council of Europe member states as of December 2015.

METHODS

The mission of the Council of Europe is to protect and promote human rights in its 47 member countries. Its 19 non-EU member states are Albania, Andorra, Armenia, Azerbaijan, Bosnia and Herzegovina, Republika Srpska, Georgia, Iceland, Liechtenstein, Republic of Moldova, Monaco, Montenegro, Norway, Russian Federation, San Marino, Serbia, Switzerland, FYR of Macedonia, Turkey, and Ukraine (EU-19). The main data source were GLOBOCAN, IARC, WHO, EUCAN, NORDCAN, ENCR, volume X of the CI5, the ministerial and Public Health Agency websites of the individual countries, PubMed, EMBASE, registries of some websites and the www.cochranelibrary.com, Scopus, www.clinicaltrials.gov, www.clinicaltrialsregister.eu, Research gate, Google and data extracted from screening programme results.

RESULTS

Our results show that epidemiological data quality varies broadly between EU-28 and EU-19 countries. In terms of incidence, only 30% of EU-19 countries rank high in data quality as opposed to 86% of EU-28 states. The same applies to mortality data, since 52% of EU-19 countries as against all EU-28 countries are found in the high ranks. Assessment of the method of collection of incidence data showed that only 32% of EU-19 countries are found in the top three quality classes as against 89% of EU-28 countries. For the mortality data, 63% of EU-19 countries are found in the highest ranks as opposed to all EU-28 member states. Interestingly, comparison of neighbouring countries offering regional screening shows, for instance, that incidence and mortality rates are respectively 38.9 and 13.0 in Norway and 29.2 and 10.9 in Sweden, whereas in Finland, where a national organised programme is available, they are respectively 23.5 and 9.3.

CONCLUSION

Cancer screening should be viewed as a key health care tool, also because investing in screening protects the weakest in the population, decreases the social burden of cancer, and reduces all types of health care costs, including those for radical surgery, long-term hospitalisation, and chemotherapy.

摘要

目的

提供截至2015年12月非欧盟(EU)-28欧洲委员会成员国的结直肠癌(CRC)筛查项目的最新情况。

方法

欧洲委员会的使命是在其47个成员国中保护和促进人权。其19个非欧盟成员国为阿尔巴尼亚、安道尔、亚美尼亚、阿塞拜疆、波斯尼亚和黑塞哥维那、塞族共和国、格鲁吉亚、冰岛、列支敦士登、摩尔多瓦共和国、摩纳哥、黑山、挪威、俄罗斯联邦、圣马力诺、塞尔维亚、瑞士、前南斯拉夫的马其顿共和国、土耳其和乌克兰(欧盟-19)。主要数据来源为全球癌症发病率和死亡率数据库(GLOBOCAN)、国际癌症研究机构(IARC)、世界卫生组织(WHO)、欧洲癌症信息网(EUCAN)、北欧癌症信息网(NORDCAN)、欧洲癌症登记处(ENCR)、国际癌症研究机构第五版(CI5)第十卷、各国的部长级和公共卫生机构网站、医学期刊数据库(PubMed)、荷兰医学文摘数据库(EMBASE)、一些网站的登记处、www.cochranelibrary.com、Scopus、www.clinicaltrials.gov、www.clinicaltrialsregister.eu、科研之门(Research gate)、谷歌以及从筛查项目结果中提取的数据。

结果

我们的结果表明,欧盟-28国家和欧盟-19国家之间的流行病学数据质量差异很大。在发病率方面,欧盟-19国家中只有30%的数据质量排名较高,而欧盟-28国家中这一比例为86%。死亡率数据情况相同,因为欧盟-19国家中有52%的数据质量排名较高,而欧盟-28国家则全部排名较高。对发病率数据收集方法的评估显示,欧盟-19国家中只有32%的数据质量处于前三个等级,而欧盟-28国家中这一比例为89%。对于死亡率数据,欧盟-19国家中有63%的数据质量排名最高,而欧盟-28所有成员国均排名最高。有趣的是,对提供区域筛查的邻国进行比较发现,例如,挪威的发病率和死亡率分别为38.9和13.0,瑞典为29.2和10.9,而在有全国性组织项目的芬兰,发病率和死亡率分别为23.5和9.3。

结论

癌症筛查应被视为一项关键的医疗保健工具,这也是因为对筛查进行投资可以保护人群中的弱势群体,减轻癌症的社会负担,并降低所有类型的医疗保健成本,包括根治性手术、长期住院和化疗的成本。

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