Global Breast Cancer Research: Moving Forward.
Global Breast Cancer Research: Moving Forward.
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DOI：
10.1200/edbk_209183
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发表时间：
2018-05-23
期刊：
影响因子：
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通讯作者：
Werutsky, Gustavo
中科院分区：
文献类型：
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作者：
Barrios, Carlos H;Reinert, Tomas;Werutsky, Gustavo
乳腺癌是一个主要的全球性健康问题和主要的死亡原因。虽然高收入国家的死亡率呈下降趋势，但低收入和中等收入国家的死亡率呈上升趋势。解决全球乳腺癌研究是一项具有挑战性的奋进，因为世界不同地区存在着显著的差异和极其异质的现实。世界卫生组织（WHO）提出的基本药物清单以及筛查和治疗资源分层指南已满足了全球基本癌症医疗保健需求。然而，需要采取具体战略，解决在获得保健服务，特别是获得新疗法方面的差距。关于全球乳腺癌研究的讨论应考虑到临床试验的持续全球化。北美和欧洲的知名研究组织促进的合作对于发展中低收入国家的基础设施和人力资源至关重要，这样这些国家的研究人员就可以开始处理区域问题。影响全球乳腺癌研究未来的具体挑战包括增加中低收入国家试验的可用性，制定提高患者参与临床试验的策略，以及为现实世界循证研究的发展制定明确的指导方针。本综述的主要目的是鼓励讨论全球乳腺癌研究中的挑战，希望我们能够共同提出可行的建议，以推动该领域的发展。
Breast cancer is a major global health problem and major cause of mortality. Although mortality trends are declining in high-income countries, trends are increasing in low- and middle-income countries (LMICs). Addressing global breast cancer research is a challenging endeavor, as notable disparities and extremely heterogeneous realities exist in different regions across the world. Basic global cancer health care needs have been addressed by the World Health Organization's (WHO) proposed list of essential medicines and by resource-stratified guidelines for screening and treatment. However, specific strategies are needed to address disparities in access to health care, particularly access to new therapies. Discussions about global research in breast cancer should take into account the ongoing globalization of clinical trials. Collaboration fostered by well-established research organizations in North America and Europe is essential for the development of infrastructure and human resources in LMICs so that researchers in these countries can begin to address regional questions. Specific challenges that impact the future of global breast cancer research include increasing the availability of trials in LMICs, developing strategies to increase patient participation in clinical trials, and creation of clear guidelines for the development of real-world evidence-based research. The main objective of this review is to encourage the discussion of challenges in global breast cancer research with the hope that collectively we will be able to generate workable proposals to advance the field.