Global cancer transitions according to the Human Development Index (2008-2030): a population-based study
Global cancer transitions according to the Human Development Index (2008-2030): a population-based study
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DOI：
10.1016/s1470-2045(12)70211-5
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发表时间：
2012-08-01
期刊：
影响因子：
51.1
通讯作者：
Forman, David
中科院分区：
文献类型：
--
作者：
Bray, Freddie;Jemal, Ahmedin;Forman, David
背景在未来的几十年里，癌症将成为世界各地区发病率和死亡率的主要原因。我们的目的是根据人类发展的不同水平来评估癌症的变化模式。人类发展指数（HDI）是预期寿命、教育和人均国内生产总值的综合指标，在2008年强调癌症的特定模式，1988-2002年（根据全球生物多样性网络的估计数）和趋势（根据五大洲癌症发病率系列），并仅根据预测的人口变化和趋势来制定2030年的未来负担情景-在2008年人类发展指数最高的地区，女性乳腺癌、肺癌、结直肠癌和前列腺癌占总癌症负担的一半，而在人类发展指数中等的地区，食道癌、胃癌和肝癌也很常见，在人类发展指数中等至非常高的地区，这七种癌症占总癌症负担的62%。在人类发展指数较低的地区，宫颈癌比乳腺癌和肝癌更常见。在184个国家的男性中，有9种不同的癌症是最常见的，其中前列腺癌、肺癌和肝癌最常见。乳腺癌和宫颈癌在妇女中最为常见。在中等人类发展指数和高人类发展指数的情况下，宫颈癌和胃癌发病率的下降似乎被女性乳腺癌、前列腺癌和结肠直肠癌发病率的增加所抵消。如果这项研究中估计的癌症特异性和性别特异性趋势继续下去，我们预测，到2030年，所有癌症病例的发病率将从2008年的1270万新发病例增加到2220万例。解释我们的研究结果表明，许多国家的快速社会和经济转型意味着，与生殖、饮食和激素因素有关的新病例越来越多，从而抵消了相关癌症的发病率。有针对性的干预措施可以通过有效的初级预防战略，以及实施疫苗接种、早期发现和有效治疗方案，减少癌症负担的预计增加。
Background Cancer is set to become a major cause of morbidity and mortality in the coming decades in every region of the world. We aimed to assess the changing patterns of cancer according to varying levels of human development.Methods We used four levels (low, medium, high, and very high) of the Human Development Index (HDI), a composite indicator of life expectancy, education, and gross domestic product per head, to highlight cancer-specific patterns in 2008 (on the basis of GLOBOCAN estimates) and trends 1988-2002 (on the basis of the series in Cancer Incidence in Five Continents), and to produce future burden scenario for 2030 according to projected demographic changes alone and trends-based changes for selected cancer sites.Findings In the highest HDI regions in 2008, cancers of the female breast, lung, colorectum, and prostate accounted for half the overall cancer burden, whereas in medium HDI regions, cancers of the oesophagus, stomach, and liver were also common, and together these seven cancers comprised 62% of the total cancer burden in medium to very high HDI areas. In low HDI regions, cervical cancer was more common than both breast cancer and liver cancer. Nine different cancers were the most commonly diagnosed in men across 184 countries, with cancers of the prostate, lung, and liver being the most common. Breast and cervical cancers were the most common in women. In medium HDI and high HDI settings, decreases in cervical and stomach cancer incidence seem to be off set by increases in the incidence of cancers of the female breast, prostate, and colorectum. If the cancer-specific and sex-specific trends estimated in this study continue, we predict an increase in the incidence of all-cancer cases from 12.7 million new cases in 2008 to 22.2 million by 2030.Interpretation Our findings suggest that rapid societal and economic transition in many countries means that any reductions in infection-related cancers are off set by an increasing number of new cases that are more associated with reproductive, dietary, and hormonal factors. Targeted interventions can lead to a decrease in the projected increases in cancer burden through effective primary prevention strategies, alongside the implementation of vaccination, early detection, and effective treatment programmes.