Borno Hala, George Daniel J, Schnipper Lowell E, Cavalli Franco, Cerny Thomas, Gillessen Silke
1 University of California, San Francisco, CA.
2 Duke University Cancer Institute, Durham, NC.
Am Soc Clin Oncol Educ Book. 2019 Jan;39:302-308. doi: 10.1200/EDBK_238879. Epub 2019 May 17.
The global cancer burden is estimated to have risen to 18.1 million new cases and 9.6 million deaths in 2018. By 2030, the number of cancer cases is projected to increase to 24.6 million and the number of cancer deaths, to 13 million. Global data mask the social and health disparities that influence cancer incidence and survival. Inequality in exposure to carcinogens, education, access to quality diagnostic services, and affordable treatments all affect the probability of survival. Worryingly, despite the fact that many cancers could be prevented by stronger public health actions and many others could be largely cured by better access to diagnostics and affordable treatments, the international community has yet to make a substantial move to tackle this challenge. In prostate cancer, studies show that there are geographic and racial/ethnic distribution differences as well as a number of other variables, including environmental factors, limited access to standard cancer treatments, reduced probability to be included in trials, and the financial burden of cancer treatments. Financial burden for the patients can result in poor adherence, increased debt, and poor long-term outcomes. The following article will discuss some of the important causes for disparity in prostate cancer and prostate cancer care, focused on the current situation in the United States, as well as possible remedies to address these causes.
据估计，2018年全球癌症负担已升至1810万例新发病例和960万例死亡病例。到2030年，癌症病例数预计将增至2460万例，癌症死亡数将增至1300万例。全球数据掩盖了影响癌症发病率和生存率的社会及健康差异。接触致癌物、教育程度、获得高质量诊断服务的机会以及可负担的治疗等方面的不平等，都会影响生存概率。令人担忧的是，尽管许多癌症可通过更有力的公共卫生行动预防，许多其他癌症可通过更好地获得诊断和可负担的治疗而得到很大程度的治愈，但国际社会尚未采取实质性行动应对这一挑战。在前列腺癌方面，研究表明存在地理和种族/族裔分布差异以及许多其他变量，包括环境因素、获得标准癌症治疗的机会有限、纳入试验的概率降低以及癌症治疗的经济负担。患者的经济负担可能导致依从性差、债务增加以及长期预后不良。以下文章将讨论前列腺癌及前列腺癌护理差异的一些重要原因，重点关注美国的现状以及解决这些原因的可能补救措施。
