Epidemiology and Biostatistics, Faculty of Public Health, Kuwait University, Kuwait.
Kuwait Cancer Control Center, Ministry of Kuwait, Kuwait.
Gulf J Oncolog. 2023 Jan;1(41):23-31.
To assess progress against cancer, trends in incidence, survival and mortality need to be interpreted simultaneously.
Data were obtained from the Kuwait Cancer Registry (KCR) for all Kuwaiti children (0-14 years) and adults (15-99 years) diagnosed with one of 18 common cancers during 2000-2013, with follow-up for vital status to 31 December 2015. World-standardised average annual incidence and mortality rates were calculated for 2000-2004, 2005-2009, 2010-2013. Five-year net survival was estimated with the Pohar Perme estimator, corrected for background mortality using life tables of all-cause mortality. Survival estimates were agestandardised using the International Cancer Survival Standard weights.
For liver cancer, five-year net survival increased from 11.4% to 13.4% for patients diagnosed between 2000-2004 and 2010-2013, while incidence and mortality rates fell from 5.5 to 3.6 and from 3.9 to 3.0 per 100,000, respectively. Similar patterns were seen for acute lymphoblastic leukaemia (ALL) and lymphoma in children. Survival and mortality remained stable for cancers of the lung, cervix and ovary, but incidence declined from 10.2 to 7.4, 4.9 to 2.4 and 5.8 to 4.3 per 100,000, respectively. For breast cancer, survival increased from 68.3% to 75.2%, while incidence and mortality rose from 45.6 to 58.7 and from 5.8 to 12.8 per 100,000, respectively. For colon cancer, incidence and mortality rates rose from 11.4 to 12.6 and from 2.3 to 5.4 per 100,000, respectively. Five-year survival fell from 64.8% to 50.2% between 2000-2004 and 2005-2009, before rising to 58.5% for 2010-2013.
Increasing survival, alongside falling incidence and mortality rates, represents progress in cancer control, attributable to effective prevention (e.g. tobacco control and lung cancer) and early diagnostic activity (e.g. mammography for breast cancer), or better treatment (e.g. childhood ALL). The increasing prevalence of obesity, linked to rising incidence for breast and colon cancers, suggests the need for public health prevention campaigns.
为了评估癌症的进展情况，需要同时解读发病率、生存率和死亡率的趋势。
数据来自科威特癌症登记处（KCR），包括 2000 年至 2013 年期间在科威特被诊断患有 18 种常见癌症之一的所有儿童（0-14 岁）和成年人（15-99 岁），随访至 2015 年 12 月 31 日。计算了 2000-2004 年、2005-2009 年和 2010-2013 年期间每 100,000 人中有 18 种癌症的世界标准化平均年发病率和死亡率。使用 Pohar Perme 估计器估算了五年净生存率，并使用全因死亡率的生命表校正了背景死亡率。使用国际癌症生存标准权重对生存估计值进行了年龄标准化。
对于肝癌，2000-2004 年和 2010-2013 年期间被诊断出的患者的五年净生存率从 11.4%上升至 13.4%，而发病率和死亡率分别从每 100,000 人 5.5 降至 3.6，从每 100,000 人 3.9 降至 3.0。儿童急性淋巴细胞白血病（ALL）和淋巴瘤也出现了类似的模式。肺癌、宫颈癌和卵巢癌的生存率和死亡率保持稳定，但发病率分别从每 100,000 人 10.2 降至 7.4、4.9 降至 2.4 和 5.8 降至 4.3。对于乳腺癌，生存率从 68.3%上升至 75.2%，而发病率和死亡率分别从每 100,000 人 45.6 上升至 58.7 和从每 100,000 人 5.8 上升至 12.8。结肠癌的发病率和死亡率分别从每 100,000 人 11.4 上升至 12.6 和从每 100,000 人 2.3 上升至 5.4。2000-2004 年和 2005-2009 年期间，五年生存率从 64.8%降至 50.2%，随后在 2010-2013 年升至 58.5%。
生存率的提高，加上发病率和死亡率的下降，代表着癌症控制方面的进展，这归因于有效的预防措施（例如烟草控制和肺癌）和早期诊断活动（例如乳腺癌的乳房 X 光检查），或者是更好的治疗方法（例如儿童 ALL）。肥胖症的患病率不断上升，与乳腺癌和结肠癌的发病率上升有关，这表明需要开展公共卫生预防运动。
