Fidler Miranda M, Bray Freddie, Soerjomataram Isabelle
Section of Cancer Surveillance, International Agency for Research on Cancer, France.
Scand J Public Health. 2018 Feb;46(1):27-36. doi: 10.1177/1403494817715400. Epub 2017 Jul 1.
This review examines the links between human development and cancer overall and for specific types of cancer, as well as cancer-related risk-factors and outcomes, such as disability and life expectancy.
To assess human development, the Human Development Index was utilized continuously and according to four levels (low, medium, high, very high), where the low and very high categories include the least and most developed countries, respectively. All studies that assessed aspects of the global cancer burden using this measure were reviewed.
Although the present cancer incidence burden is greater in higher Human Development Index countries, a greater proportion of the global mortality burden is observed in less developed countries, with a higher mean fatality rate in the latter countries. Further, the future cancer burden is expected to disproportionally affect less developed regions; in particular, it has been estimated that low and medium Human Development Index countries will experience a 100% and 81% increase in cancer incidence from 2008 to 2030, respectively. Disparities were also observed in risk factors and average health outcomes, such as a greater number of years of life lost prematurely and fewer cancer-related gains in life expectancy observed in lower versus higher Human Development Index settings.
From a global perspective, there remain clear disparities in the cancer burden according to national Human Development Index scores. International efforts are needed to aid countries in social and economic transition in order to efficiently plan, implement and evaluate cancer control initiatives as a means to reduce the widening gap in cancer occurrence and survival worldwide.
本综述探讨人类发展与总体癌症以及特定类型癌症之间的联系，以及与癌症相关的风险因素和后果，如残疾和预期寿命。
为评估人类发展，持续使用人类发展指数并根据四个水平（低、中、高、非常高）进行划分，其中低水平和非常高水平类别分别包括最不发达国家和最发达国家。对所有使用该指标评估全球癌症负担各个方面的研究进行了综述。
尽管目前癌症发病率负担在人类发展指数较高的国家更大，但全球死亡率负担的更大比例出现在较不发达国家，后者的平均死亡率更高。此外，预计未来癌症负担将对较不发达地区产生不成比例的影响；特别是，据估计，人类发展指数低和中等的国家从2008年到2030年癌症发病率将分别增加100%和81%。在风险因素和平均健康结果方面也存在差异，例如在人类发展指数较低与较高的环境中，过早失去的生命年数更多，与癌症相关的预期寿命增加更少。
从全球角度来看，根据国家人类发展指数得分，癌症负担仍存在明显差异。需要开展国际努力，帮助处于社会和经济转型期的国家，以便有效地规划、实施和评估癌症控制举措，作为缩小全球癌症发生和生存差距的一种手段。
