Breast cancer in Singapore: some perspectives
Breast cancer in Singapore: some perspectives
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DOI：
10.1007/s12282-009-0155-3
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发表时间：
2010-01-01
期刊：
影响因子：
4
通讯作者：
Tan, Puay Hoon
中科院分区：
文献类型：
--
作者：
Jara-Lazaro, Ana Richelia;Thilagaratnam, Shyamala;Tan, Puay Hoon
乳腺癌是新加坡女性最常见的恶性肿瘤，占所有女性癌症的29.7%，年龄标化发病率为每年54.9/10万。在过去的30年里，它一直是新加坡女性最常见的癌症，以前报告的发病率在45岁到49岁之间的人群中最高，但最近的观察显示，高峰期年龄组发生了变化，女性到了50多岁。在新加坡，每年约有1100例新确诊病例，约270名妇女死于乳腺癌。在新加坡的多民族人口中，人们已经注意到，乳腺癌发病率的上升在所有三个民族(华人、马来人和印度人)中都是一致的。新加坡是亚洲乳腺癌发病率最高的国家之一。可能的解释包括快速的城市化，社会经济地位的提高，以及采用西方的生活方式。我们在新加坡乳房筛查试点项目(1994-1997)和全国乳房筛查项目(BreastScreen新加坡)的经验使我们在该国增加了对这种疾病的了解。试点项目的数据显示，乳房筛查在以亚洲人为主的人群中与在西方国家一样有效。早期乳腺癌占大多数发现的乳腺癌，在初步研究中，浸润性导管原位癌(DCIS)占所有筛查发现的癌症的26%。在目前正在进行的新加坡乳腺癌筛查中，DCIS占绝经前女性所有乳腺癌的30%，这一比例相对较高，部分原因可能是年龄在40岁至49岁之间的女性更多地参与其中。尽管有现成的补贴乳房X光检查，新加坡仍有妇女患有当地晚期乳腺癌。越来越多的乳腺癌妇女的临床管理采用基于多学科团队的方法，并在肿瘤委员会定期讨论治疗策略。为了提高我国乳腺癌的诊断和治疗水平，对从事乳腺癌诊断和治疗的医学专业人员进行持续的乳腺癌和乳腺疾病相关教育活动是非常重要的。公共教育在提高认识方面的作用也是至关重要的。
Breast cancer is the commonest malignancy among Singapore women, accounting for 29.7% of all female cancers, with an age-standardized rate of 54.9 per 100,000 per year. It has been the most frequent cancer in Singapore women for the last 30 years, with the highest rates previously reported in those aged between 45 and 49 years, but with a more recent observation of a change in peak age group to women in their late 50s. About 1,100 new cases are diagnosed annually and approximately 270 women die in Singapore each year from breast cancer. In the multiethnic population of Singapore, it has been noted that rising breast cancer incidence is consistent across all three ethnic groups (Chinese, Malays, and Indians). Singapore has among the highest breast cancer incidence in Asia. Possible explanations include rapid urbanization, improvement in socio-economic status, and adoption of a western lifestyle. Our experience with the Singapore breast screening pilot project (1994-1997) and the national breast-screening program (BreastScreen Singapore) has led to increased understanding of this disease in the country. Data from the pilot project showed that breast screening is just as effective in a predominantly Asian population as in the west. Early breast cancer accounted for most breast cancers detected, with pre-invasive ductal carcinoma in situ (DCIS) comprising 26% of all screen-detected cancers in the pilot study. In the currently on-going BreastScreen Singapore, DCIS forms > 30% of all breast cancers among pre-menopausal women, a relatively high proportion probably accounted for partially by the greater participation of women aged between 40 and 49 years. Despite the ready availability of subsidized mammographic screening, there are still women in Singapore who present with locally advanced breast cancer. Clinical management of an increasing number of women with breast cancer embraces a multidisciplinary team-based approach, with regular discussions of therapeutic strategies at tumor boards. In order to improve breast cancer diagnostics and therapeutics in our country, it is important that there are continual breast cancer and breast disease-related educational activities for medical professionals engaged in diagnosing and managing breast cancer. The role of public education in raising awareness is also essential.