Melaku Yohannes Adama, Appleton Sarah L, Gill Tiffany K, Ogbo Felix A, Buckley Elizabeth, Shi Zumin, Driscoll Tim, Adams Robert, Cowie Benjamin C, Fitzmaurice Christina
Adelaide Medical School, The University of Adelaide, Adelaide, Australia; Department Human Nutrition, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
The Health Observatory, Discipline of Medicine, The University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, South Australia, Australia; Freemason's Centre for Men's Health, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia.
Cancer Epidemiol. 2018 Feb;52:43-54. doi: 10.1016/j.canep.2017.11.007. Epub 2017 Dec 5.
Comparative evidence on the burden, trend, and risk factors of cancer is limited. Using data from the Global Burden of Disease (GBD) study, we aimed to assess cancer burden - incidence, prevalence, mortality, disability-adjusted life years (DALYs) - and attributable risk factors for Australia between 1990 and 2015, and to compare them with those of 34 members of the Organisation for Economic Co-operation and Development (OECD).
The general GBD cancer estimation methods were used with data input from vital registration systems and cancer registries. A comparative risk assessment approach was used to estimate the population-attributable fractions due to risk factors.
In 2015 there were 198,880 (95% uncertainty interval [UI]: 183,908-217,365) estimated incident cancer cases and 47,562 (95% UI: 46,061-49,004) cancer deaths in Australia. Twenty-nine percent (95% UI: 28.2-29.8) of total deaths and 17.0% (95% UI: 15.0-19.1) of DALYs were caused by cancer in Australia in 2015. Cancers of the trachea, bronchus and lung, colon and rectum, and prostate were the most common causes of cancer deaths. Thirty-six percent (95% UI: 33.1-37.9) of all cancer deaths were attributable to behavioral risks. The age-standardized cancer incidence rate (ASIR) increased between 1990 and 2015, while the age-standardized cancer death rate (ASDR) decreased over the same period. In 2015, compared to 34 other OECD countries Australia ranked first (highest) and 24 based on ASIR and ASDR, respectively.
The incidence of cancer has increased over 25 years, and behavioral risks are responsible for a large proportion of cancer deaths. Scaling up of prevention (using strategies targeting cancer risk factors), early detection, and treatment of cancer is required to effectively address this growing health challenge.
关于癌症负担、趋势及风险因素的比较证据有限。利用全球疾病负担（GBD）研究的数据，我们旨在评估1990年至2015年澳大利亚的癌症负担——发病率、患病率、死亡率、伤残调整生命年（DALYs）——以及可归因风险因素，并将其与经济合作与发展组织（OECD）34个成员国的情况进行比较。
采用一般的GBD癌症估算方法，并输入来自生命登记系统和癌症登记处的数据。采用比较风险评估方法来估算风险因素导致的人群归因分数。
2015年澳大利亚估计有198,880例（95%不确定区间[UI]：183,908 - 217,365）新发癌症病例和47,562例（95% UI：46,061 - 49,004）癌症死亡病例。2015年在澳大利亚，癌症导致的死亡占总死亡人数的29%（95% UI：28.2 - 29.8），占伤残调整生命年的17.0%（95% UI：15.0 - 19.1）。气管、支气管和肺癌、结肠直肠癌以及前列腺癌是癌症死亡的最常见原因。所有癌症死亡病例的36%（95% UI：33.1 - 37.9）可归因于行为风险。1990年至2015年期间，年龄标准化癌症发病率（ASIR）上升，而年龄标准化癌症死亡率（ASDR）同期下降。2015年，与其他34个经合组织国家相比，澳大利亚的年龄标准化癌症发病率和年龄标准化癌症死亡率分别排名第1（最高）和第24位。
25年来癌症发病率有所上升，行为风险导致了很大一部分癌症死亡。需要扩大预防（采用针对癌症风险因素的策略）、早期检测和癌症治疗，以有效应对这一日益严峻的健康挑战。
