Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium.
International Centre for Reproductive Health (ICRH), Ghent University, 9000 Ghent, Belgium.
Int J Environ Res Public Health. 2022 Feb 25;19(5):2674. doi: 10.3390/ijerph19052674.
With cancer accounting for 19% of deaths and projected to rise in the coming years, Ecuador's inequities in healthcare coverage remain a major concern for the rural, indigenous populations. While the cancer burden among this vulnerable population has been much publicized in the context of the controversial oil extraction in the Amazon, there is contradictory evidence on its occurrence and determinants. This review critically discusses the available literature on cancer among indigenous people in Ecuador and explores the link between oil exploitation and cancer occurrence among indigenous people using a scoping review approach. The results of this review show there is a clear but inconsistent association between oil exposure and cancer risk in indigenous populations of Ecuador. While the environmental magnitude of oil extraction in this region is a topic of debate, our findings point to the interplay with social determinants and other sources of carcinogenic compounds, which exacerbates the risks faced by indigenous communities. Based on these findings, this study puts forward three arguments to contextualize the occurrence of cancer related to oil exploitation in the Amazon, and puts forth key recommendations for public health initiatives embedded within the local community.
由于癌症占死亡人数的 19%，预计未来几年还会上升，厄瓜多尔在医疗保健覆盖方面的不平等现象仍然是农村和土著人口的主要关注点。尽管在亚马逊地区有争议的石油开采背景下，已经对这个弱势群体的癌症负担进行了大量宣传，但关于其发生和决定因素的证据却相互矛盾。本综述批判性地讨论了厄瓜多尔土著人群中癌症的现有文献，并通过范围综述方法探讨了石油开采与土著人群癌症发生之间的联系。本综述的结果表明，在厄瓜多尔的土著人群中，石油暴露与癌症风险之间存在明显但不一致的关联。虽然该地区石油开采的环境规模是一个有争议的话题，但我们的研究结果表明，这与社会决定因素和其他致癌化合物来源相互作用，加剧了土著社区面临的风险。基于这些发现，本研究提出了三个论点，将与亚马逊地区石油开采有关的癌症发生情况置于具体背景下，并提出了三个关键建议，作为嵌入当地社区的公共卫生倡议的一部分。
