Sierra Mónica S, Soerjomataram Isabelle, Antoni Sébastien, Laversanne Mathieu, Piñeros Marion, de Vries Esther, Forman David
International Agency for Research on Cancer, Section of Cancer Surveillance, France.
International Agency for Research on Cancer, Section of Cancer Surveillance, France.
Cancer Epidemiol. 2016 Sep;44 Suppl 1:S23-S42. doi: 10.1016/j.canep.2016.07.013.
Cancer burden is increasing in Central and South America (CSA). We describe the current burden of cancer in CSA.
We obtained regional and national-level cancer incidence data from 48 population-based registries (13 countries) and nation-wide cancer mortality data from the WHO (18 countries). We estimated world population age-standardized incidence and mortality rates per 100,000 person-years.
The leading cancers diagnosed were prostate, lung, breast, cervix, colorectal, and stomach, which were also the primary causes of cancer mortality. Countries of high/very high human development index (HDI) in the region experienced a high burden of prostate and breast cancer while medium HDI countries had a high burden of stomach and cervical cancers. Between countries, incidence and mortality from all cancers combined varied by 2-3-fold. French Guyana, Brazil, Uruguay, and Argentina had the highest incidence of all cancers while Uruguay, Cuba, Argentina, and Chile had the highest mortality. Incidence of colorectum, prostate and thyroid cancers increased in Argentina, Brazil, Chile and Costa Rica from 1997 to 2008, while lung, stomach and cervical cancers decreased.
CSA carries a double-burden of cancer, with elevated rates of infection- and lifestyle-related cancers. Encountered variation in cancer rates between countries may reflect differences in registration practices, healthcare access, and public awareness. Resource-dependent interventions to prevent, early diagnose, and treat cancer remain an urgent priority. There is an overwhelming need to improve the quality and coverage of cancer registration to guide and evaluate future cancer control policies and programs.
中美洲和南美洲(CSA)的癌症负担正在增加。我们描述了CSA目前的癌症负担情况。
我们从48个基于人群的登记处(13个国家)获取了区域和国家层面的癌症发病率数据,并从世界卫生组织(18个国家)获取了全国癌症死亡率数据。我们估计了每10万人年的世界人口年龄标准化发病率和死亡率。
诊断出的主要癌症是前列腺癌、肺癌、乳腺癌、宫颈癌、结直肠癌和胃癌,这些也是癌症死亡的主要原因。该地区人类发展指数高/非常高的国家前列腺癌和乳腺癌负担较重,而中等人类发展指数国家胃癌和宫颈癌负担较重。各国之间,所有癌症的发病率和死亡率综合起来相差2至3倍。法属圭亚那、巴西、乌拉圭和阿根廷所有癌症的发病率最高,而乌拉圭、古巴、阿根廷和智利的死亡率最高。1997年至2008年,阿根廷、巴西、智利和哥斯达黎加的结直肠癌、前列腺癌和甲状腺癌发病率上升,而肺癌、胃癌和宫颈癌发病率下降。
CSA承受着癌症的双重负担,与感染和生活方式相关的癌症发病率较高。各国癌症发病率的差异可能反映了登记做法、医疗保健可及性和公众意识方面的差异。依赖资源的癌症预防、早期诊断和治疗干预措施仍然是当务之急。迫切需要提高癌症登记的质量和覆盖范围,以指导和评估未来的癌症控制政策和计划。