Torre Lindsey A, Islami Farhad, Siegel Rebecca L, Ward Elizabeth M, Jemal Ahmedin
Intramural Research, American Cancer Society, Atlanta, Georgia.
Cancer Epidemiol Biomarkers Prev. 2017 Apr;26(4):444-457. doi: 10.1158/1055-9965.EPI-16-0858. Epub 2017 Feb 21.
There are striking disparities in the global cancer burden in women, yet few publications highlight cancer occurrence in this population, particularly for cancers that are not sex specific. This article, the first in a series of two, summarizes the current burden, trends, risk factors, prevention, early detection, and survivorship of all cancers combined and seven sites (breast, cervix, uterine corpus, ovary, colorectum, lung, and liver) that account for about 60% of the cancer burden among women worldwide, using data from the International Agency for Research on Cancer. Estimated 2012 overall cancer death rates in general are higher among women in low- and middle-income countries (LMICs) than high-income countries (HICs), despite their lower overall incidence rates, largely due to inadequate access to early detection and treatment. For example, the top mortality rates are in Zimbabwe (147 deaths per 100,000) and Malawi (138). Furthermore, incidence rates of cancers associated with economic development (e.g., lung, breast, colorectum) are rising in several LMICs. The burden of cancer among women could be substantially reduced in both HICs and LMICs through broad and equitable implementation of effective interventions, including tobacco control, HPV and HBV vaccination, and screening (breast, cervix, and colorectum).
全球女性癌症负担存在显著差异,但很少有出版物关注这一人群中的癌症发生情况,尤其是非性别特异性癌症。本文是系列文章中的第一篇,利用国际癌症研究机构的数据,总结了所有癌症以及占全球女性癌症负担约60%的七个部位(乳腺癌、宫颈癌、子宫体癌、卵巢癌、结直肠癌、肺癌和肝癌)的当前负担、趋势、风险因素、预防、早期检测和生存情况。尽管低收入和中等收入国家(LMICs)的总体发病率较低,但2012年估计的总体癌症死亡率普遍高于高收入国家(HICs),这主要是由于早期检测和治疗的可及性不足。例如,死亡率最高的是津巴布韦(每10万人中有147人死亡)和马拉维(每10万人中有138人死亡)。此外,在一些低收入和中等收入国家,与经济发展相关的癌症(如肺癌、乳腺癌、结直肠癌)发病率正在上升。通过广泛、公平地实施有效的干预措施,包括烟草控制、人乳头瘤病毒和乙肝疫苗接种以及筛查(乳腺癌、宫颈癌和结直肠癌),高收入国家和低收入和中等收入国家的女性癌症负担都可以大幅减轻。