Guerra-Londono Carlos E, Uribe-Marquez Santiago, Shah Rupen, Gottumukkala Vijaya
Department of Anesthesiology, Pain Management and Perioperative Medicine, Henry Ford Health, Detroit, MI, USA.
Department of Surgery, Henry Ford Health, Detroit, MI, USA.
Anaesthesia. 2025 Feb;80 Suppl 2:3-11. doi: 10.1111/anae.16514. Epub 2025 Jan 8.
Most patients with cancer will require surgery at some point in their lifetime. As the global burden of cancer continues to increase, changes and challenges in cancer epidemiology and care are also borne peri-operatively.
Due to its broad scope, a formal systematic electronic literature search was not performed. This narrative review examines how an increasing global burden of cancer affects anaesthesia and peri-operative medicine. We aimed to describe current cancer statistics; economic implications; the increasing survival of individuals with cancer; and the role of anaesthetists in enhancing the quality of life and survival after oncological surgery.
Epidemiological reports show wide variation in cancer incidence and mortality worldwide. Countries with a lower human development index will be disproportionately affected by greater increases in cancer burden. At the same time, these countries will also suffer larger deficits in the surgical and anaesthetic workforce. Cancer has significant macro- and micro-economic implications. Thus, public health and policy should address the large economic burden of cancer surgery and care. The improvement in cancer-related survival can be attributed to research focused on a deeper understanding of tumour biology; effective awareness education campaigns and screening programmes; early diagnosis; newer cancer therapies; and patient-centred precision care. Increasing survival brings new global challenges, such as delivering an adequate survivorship care plan and addressing long-term psychosocial concerns in survivors. Anaesthetists are involved in all phases of a patient's cancer journey including facilitating diagnostic procedures; providing comprehensive peri-operative care needs for ablative procedures; provision of critical care; addressing acute and chronic pain; and provision of integrative and palliative care services.
Deeper engagement of anaesthetists in cancer care programmes will be instrumental in reducing postoperative complications; improving the quality of life for patients; enhancing population health; and contributing to improved global economies.
大多数癌症患者在其一生中的某个阶段都需要进行手术。随着全球癌症负担持续增加，癌症流行病学和护理方面的变化与挑战也在围手术期出现。
由于范围广泛，未进行正式的系统电子文献检索。本叙述性综述探讨全球癌症负担的增加如何影响麻醉和围手术期医学。我们旨在描述当前的癌症统计数据；经济影响；癌症患者生存率的提高；以及麻醉医生在提高肿瘤手术后生活质量和生存率方面的作用。
流行病学报告显示全球癌症发病率和死亡率差异很大。人类发展指数较低的国家将受到癌症负担更大幅度增加的不成比例影响。与此同时，这些国家在外科和麻醉劳动力方面也将面临更大的短缺。癌症具有重大的宏观和微观经济影响。因此，公共卫生和政策应应对癌症手术和护理的巨大经济负担。与癌症相关的生存率提高可归因于专注于更深入了解肿瘤生物学的研究；有效的提高认识教育活动和筛查计划；早期诊断；更新的癌症治疗方法；以及以患者为中心的精准护理。生存率的提高带来了新的全球挑战，例如提供充分的生存护理计划以及解决幸存者的长期心理社会问题。麻醉医生参与患者癌症治疗过程的各个阶段，包括协助诊断程序；为消融手术提供全面的围手术期护理需求；提供重症监护；处理急性和慢性疼痛；以及提供综合和姑息治疗服务。
麻醉医生更深入地参与癌症护理计划将有助于减少术后并发症；提高患者生活质量；改善人群健康；并为全球经济的改善做出贡献。
