全球癌症熱點圖:患癌負擔轉至發展中國家大綱

The global burden of cancer is shifting dramatically. Once considered a disease of the wealthy, it now has a significant impact in every region, and the greatest proportional increases in cases in the coming years are predicted to be in the poorest corners of the world. Worldwide, an estimated 14.1 million new cancer cases were diagnosed in 2012 and 8.2 million cancer deaths.

全球的癌症負擔有了巨大轉變。以前人們把癌症視爲“富人病”，現在這種病卻給全球帶來了巨大影響。未來幾年中，患癌比例的最高增幅預計會出現在世界上最窮的地區。2012年全球新增癌症病例約1410萬例，死亡患者達820萬人。

In an analysis that maps the world's hot spots for cancer, epidemiologist Lindsey Torre found a tremendous heterogeneity in which forms of the disease are most commonly diagnosed in different countries.

在全球癌症熱點分佈圖中，流行病學家林德賽·托爾發現了一種極不均勻的分佈特點——各國常患癌症的類型各不相同。

Among the most significant trends they identified is a growing inequality between high-income countries and lower-income countries in cancer diagnoses — with cancer rates declining in high-income countries but rising in lower-income countries.

他們發現，最突出的一個趨勢便是高收入國家和低收入國家在患癌率上越來越不均衡——高收入國家的癌症患病率下降，而低收入國家的癌症患病率上升。

The difference is especially striking in lung, colorectal and breast cancer. Better screening, early detection and access to treatment plus a decrease in risk factors like smoking probably explain part of the positive trend among the high-income countries.

其中，以肺癌、結腸癌和乳腺癌的差距尤甚。或許更好的篩查條件、早發現早治療以及類似吸菸等誘因的減少能解釋高收入國家癌症患病率下降的原因。

As for the rising cancer rates in lower-income countries, "it's related to the adoption of a Western lifestyle," Torre explained in an interview. "People are less active," she said. "There is less manual labor and more use of transport. They have access to perhaps more appealing but less healthy foods."

托爾在一次採訪中說道，至於低收入國家的癌症患病率爲什麼越來越高，“或許是與採用西方的生活方式有關。”他說道，“人們的運動越來越少。體力勞動減少，交通工具的使用增多，人們還可以吃到更美味但並不是那麼健康的食物。”

Developing countries also bear a disproportionate burden of infection-related cancers related to the stomach bug helicobacter pylori, hepatitis and human papillomavirus (HPV).

在幽門螺桿菌、肝炎和人乳頭瘤病毒（HPV）等能致使腸胃細菌感染的感染性相關癌症上，發展中國家的負擔也並不均衡。

Addressing this inequality is critical, the researchers wrote in the journal Cancer Epidemiology, Biomarkers & Prevention, because "a large proportion of cancers can be prevented through measures including tobacco control, vaccination, early detection, and promotion of healthy lifestyles."

研究人員在期刊《癌症流行病學、生物標記及預防》上寫道，解決不均衡現象至關重要，因爲“採取預防措施能大幅減少癌症患病率，比如控煙、接種疫苗、及早發現和推廣健康的生活方式。”

"In addition, the burden of suffering can be reduced through appropriate treatment and palliative care. To apply these cancer control measures equitably around the world, a concerted effort will be required not only from individual country governments but also from international agencies, donors, civil society," they said.

他們還說道，“此外，患病的痛苦也可以通過適當的治療和姑息護理得到減緩。要想在全球範圍內均衡地推廣這些管控手段，不僅需要各國政府的齊心協力，國際機構、捐贈者和公民社會也要傾力合作。”

Torre and her colleagues at the American Cancer Society analyzed incidence and mortality data for 2003-2007 from the International Agency for Research on Cancer databases and mortality data from the World Health Organization through 2012. They selected 50 countries selected to represent various regions of the world and focused on eight major cancers.

托爾和來自美國癌症學會的幾位同事分析了國際癌症研究機構的數據庫中，2003年-2007年癌症患者的發病率和死亡率，還研究了世界衛生組織2012年的死亡率數據。他們選出50個分佈在世界各地的國家，並着手調查這些國家中八種主要癌症的發病情況。

Among males, prostate cancer is the most commonly diagnosed cancer in most countries, with the exception of those in Eastern Europe where lung cancer is the No. 1 cancer. Among females, breast cancer is the most common among those in North America, Europe and Oceania. There's more diversity in Asia, where lung cancer ranks first in China and North Korea, liver in Laos and Mongolia and thyroid in South Korea.

男性中，大多數國家最常確診的癌症是前列腺癌，但東歐地區發病率最高的卻是肺癌。女性中，北美、歐洲和大洋洲發病率最高的是乳腺癌。亞洲癌症發病的類型較多，中國和朝鮮排名第一的癌症是肺癌，老撾和蒙古則是肝癌，韓國是甲狀腺癌。