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前列腺癌负担与人类发展指数相关:来自87个国家(1990 - 2016年)的证据

The burden of prostate cancer is associated with human development index: evidence from 87 countries, 1990-2016.

作者信息

Sharma Rajesh

机构信息

University School of Management and Entrepreneurship, Delhi Technological University, East Delhi Campus, Room No. 305, Vivek Vihar Phase II, Delhi, 110095 India.

出版信息

EPMA J. 2019 May 8;10(2):137-152. doi: 10.1007/s13167-019-00169-y. eCollection 2019 Jun.

Abstract

AIM

To examine the temporal patterns of the prostate cancer burden and its association with human development.

SUBJECT AND METHODS

The estimates of the incidence and mortality of prostate cancer for 87 countries were obtained from the Global Burden of Disease 2016 study for the period 1990 to 2016. The human development level of a country was measured using its human development index (HDI): a summary indicator of health, education, and income. The association between the burden of prostate cancer and the human development index (HDI) was measured using pairwise correlation and bivariate regression. Mortality-to-incidence ratio (MIR) was employed as a proxy for the survival rate of prostate cancer.

RESULTS

Globally, 1.4 million new cases of prostate cancer arose in 2016 claiming 380,916 lives which more than doubled from 579,457 incident cases and 191,687 deaths in 1990. In 2016, the age-standardised incidence rate (ASIR) was the highest in very high-HDI countries led by Australia with ASIR of 174.1/100,000 and showed a strong positive association with HDI ( = 0.66); the age-standardised mortality rate (ASMR), however, was higher in low-HDI countries led by Zimbabwe with ASMR of 78.2/100,000 in 2016. Global MIR decreased from 0.33 in 1990 to 0.26 in 2016. Mortality-to-incidence ratio (MIR) exhibited a negative gradient ( = - 0.91) with human development index with tenfold variation globally with seven countries recording MIR in excess of 1 with the USA recording the minimum MIR of 0.10.

CONCLUSION

The high mortality and lower survival rates in less-developed countries demand all-inclusive solutions ranging from cost-effective early screening and detection to cost-effective cancer treatment. In tackling the rising burden of prostate cancer predictive, preventive and personalised medicine (PPPM) can play a useful role through prevention strategies, predicting PCa more precisely and accurately using a multiomic approach and risk-stratifying patients to provide personalised medicine.

摘要

目的

研究前列腺癌负担的时间模式及其与人类发展的关联。

对象与方法

从《2016年全球疾病负担》研究中获取了87个国家1990年至2016年期间前列腺癌发病率和死亡率的估计数据。使用人类发展指数(HDI)衡量一个国家的人类发展水平,HDI是健康、教育和收入的综合指标。采用成对相关性和双变量回归分析前列腺癌负担与人类发展指数(HDI)之间的关联。采用死亡率与发病率之比(MIR)作为前列腺癌生存率的替代指标。

结果

2016年全球新增前列腺癌病例140万例,死亡380916例,与1990年的579457例发病病例和191687例死亡相比增加了一倍多。2016年,年龄标准化发病率(ASIR)在以澳大利亚为首的极高HDI国家中最高,ASIR为174.1/10万,且与HDI呈强正相关(r = 0.66);然而,年龄标准化死亡率(ASMR)在以津巴布韦为首的低HDI国家中较高,2016年ASMR为78.2/10万。全球MIR从1990年的0.33降至2016年的0.26。死亡率与发病率之比(MIR)与人类发展指数呈负梯度(r = -0.91),全球范围内相差10倍,有7个国家的MIR超过1,美国的MIR最低,为0.10。

结论

欠发达国家的高死亡率和较低生存率需要全面的解决方案,包括具有成本效益的早期筛查和检测以及具有成本效益的癌症治疗。在应对不断上升的前列腺癌负担方面,预测、预防和个性化医学(PPPM)可以通过预防策略、使用多组学方法更精确准确地预测前列腺癌以及对患者进行风险分层以提供个性化医学发挥有益作用。

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