Colorectal Cancer: National and International Perspective on the Burden of Disease and Public Health Impact
Colorectal Cancer: National and International Perspective on the Burden of Disease and Public Health Impact
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DOI：
10.1053/j.gastro.2010.01.056
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发表时间：
2010-06-01
期刊：
影响因子：
29.4
通讯作者：
Provenzale, Dawn
中科院分区：
文献类型：
--
作者：
Gellad, Ziad F.;Provenzale, Dawn
结直肠癌是美国和全世界发病率和死亡率的重要原因。鉴于筛查和监测结肠镜检查是临床实践的主要部分，这种疾病对胃肠病学家的重要性不容低估。据报道，美国是世界上唯一一个结直肠癌发病率和死亡率显著下降的国家，但癌症筛查，治疗和生存方面的健康差异仍然存在。世界各地的健康差距也很明显，这一疾病的影响令人震惊。事实上，世界上许多地方的癌症发病率正在上升。消除癌症筛查和治疗的障碍可以大大提高生活质量和数量，并减少结直肠癌对公共卫生的负担。尽管最佳筛查策略仍存在争议，但程序性和机会性筛查计划已经对疾病负担产生了可衡量的影响。世界各地的筛查方案各不相同，由于各国政治和财政现实的差异，进一步完善将需要采取量身定制的方法。尽管结直肠癌对公共卫生产生了巨大影响，但仍有理由保持乐观，并有希望的空间。
Colorectal cancer is a significant cause of morbidity and mortality in the United States and throughout the world. The importance of this disease to gastroenterologists cannot be understated, given that screening and surveillance colonoscopy are dominant segments of clinical practice. The United States is the only country in the world where incidence and mortality rates from colorectal cancer are reported to be decreasing significantly, but health disparities in cancer screening, treatment, and survival persist. Health disparities are also evident worldwide, where the impact of this disease is staggering. In fact, rates of cancer are increasing in many parts of the world. Eliminating barriers to cancer screening and treatment could lead to substantial gains in quality and quantity of life and decrease the burden of colorectal cancer on public health. Programmatic and opportunistic screening programs have already had a measurable impact on disease burden, although the optimal screening strategy remains a matter of debate. Screening programs vary throughout the world, and further refinement will require a tailored approach because of differences in politics and fiscal reality among individual countries. Despite the strong impact of colorectal cancer on public health, there is cause for optimism and room for hope.