Olver I
Sansom Institute for Health Research, University of South Australia, Adelaide, SA, 5001, Australia.
Eur J Cancer Care (Engl). 2017 Jan;26(1). doi: 10.1111/ecc.12654.
Disparities in cancer control exist in low- and middle-income countries (LMICs). Many countries do not have cancer registries to record incidence, mortality and prevalence and are reliant on Globocan estimates of their cancer burden. Poorer cancer control within and between countries occurs in those living remotely from urban centres, those in a low socioeconomic group and some ethnic groups who have lifestyle and belief systems which impact on cancer control. High-income countries generally have population screening programmes for cervix, breast and bowel cancer. However, simpler forms of screening for cancer of the cervix like visual inspection with acetic acid have been shown to be feasible in developing nations. The widespread use of vaccines to prevent cancer has been achieved with the Hepatitis B vaccine but the human papilloma virus vaccine to prevent cancer of the cervix is largely only available in high-income countries. Access to and training of oncological surgeons in LMICs is limited, while 70% of patients in these countries cannot access radiotherapy. The World Health Organization has developed a list of essential medicines although access remains poor in LMICs. The United Nations has set targets for the control of non-communicable diseases to improve global cancer control.
低收入和中等收入国家（LMICs）在癌症控制方面存在差异。许多国家没有癌症登记处来记录发病率、死亡率和患病率，而是依赖全球癌症负担估计（Globocan）来了解本国的癌症负担情况。在国家内部和国家之间，癌症控制较差的情况出现在居住在远离城市中心的人群、社会经济地位较低的人群以及一些生活方式和信仰体系对癌症控制有影响的族裔群体中。高收入国家通常有针对宫颈癌、乳腺癌和结直肠癌的人群筛查项目。然而，事实证明，在发展中国家，像醋酸目视检查这样更简单的宫颈癌筛查形式是可行的。通过乙肝疫苗已经实现了广泛使用疫苗预防癌症，但预防宫颈癌的人乳头瘤病毒疫苗在很大程度上仅在高收入国家可用。低收入和中等收入国家肿瘤外科医生的获取和培训有限，而这些国家70%的患者无法获得放射治疗。世界卫生组织已经制定了基本药物清单，尽管在低收入和中等收入国家，药物可及性仍然很差。联合国已经设定了控制非传染性疾病的目标，以改善全球癌症控制。
