Bizuayehu Habtamu Mellie, Dadi Abel F, Hassen Tahir A, Ketema Daniel Bekele, Ahmed Kedir Y, Kassa Zemenu Y, Amsalu Erkihun, Kibret Getiye Dejenu, Alemu Addisu Alehegn, Alebel Animut, Shifa Jemal E, Assefa Yibeltal, Tessema Gizachew A, Sarich Peter, Gebremedhin Aster Ferede, Bore Meless G
School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia.
Int J Cancer. 2024 Apr 15;154(8):1377-1393. doi: 10.1002/ijc.34809. Epub 2023 Dec 7.
Globally women face inequality in cancer outcomes; for example, smaller improvements in life expectancy due to decreased cancer-related deaths than men (0.5 vs 0.8 years, 1981-2010). However, comprehensive global evidence on the burden of cancer among women (including by reproductive age spectrum) as well as disparities by region, remains limited. This study aimed to address these evidence gaps by considering 34 cancer types in 2020 and their projections for 2040. The cancer burden among women in 2020 was estimated using population-based data from 185 countries/territories sourced from GLOBOCAN. Mortality to Incidence Ratios (MIR), a proxy for survival, were estimated by dividing the age-standardised mortality rates by the age-standardised incidence rates. Demographic projections were performed to 2040. In 2020, there were an estimated 9.3 million cancer cases and 4.4 million cancer deaths globally. Projections showed an increase to 13.3 million (↑44%) and 7.1 million (↑60%) in 2040, respectively, with larger proportional increases in low- and middle-income countries. MIR among women was higher (poorer survival) in rare cancers and with increasing age. Countries with low Human Development Indexes (HDIs) had higher MIRs (69%) than countries with very high HDIs (30%). There was inequality in cancer incidence and mortality worldwide among women in 2020, which will further widen by 2040. Implementing cancer prevention efforts and providing basic cancer treatments by expanding universal health coverage through a human rights approach, expanding early screening opportunities and strengthening medical infrastructure are key to improving and ensuring equity in cancer control and outcomes.
在全球范围内,女性在癌症治疗结果上面临不平等;例如,与男性相比,因癌症相关死亡减少而带来的预期寿命改善幅度较小(1981 - 2010年为0.5年对0.8年)。然而,关于全球女性癌症负担(包括按生育年龄谱划分)以及地区差异的全面证据仍然有限。本研究旨在通过考虑2020年的34种癌症类型及其2040年的预测情况来填补这些证据空白。利用来自GLOBOCAN的185个国家/地区基于人群的数据估算了2020年女性的癌症负担。通过将年龄标准化死亡率除以年龄标准化发病率来估算死亡率与发病率之比(MIR),以此作为生存率的替代指标。进行了到2040年的人口预测。2020年,全球估计有930万例癌症病例和440万例癌症死亡。预测显示,到2040年这两个数字将分别增至1330万(增长44%)和710万(增长60%),低收入和中等收入国家的增长比例更大。在罕见癌症以及随着年龄增长的情况下,女性的MIR更高(生存率更低)。人类发展指数低的国家的MIR(69%)高于人类发展指数非常高的国家(30%)。2020年全球女性在癌症发病率和死亡率方面存在不平等,到2040年这种不平等将进一步加剧。通过人权方法扩大全民健康覆盖、增加早期筛查机会以及加强医疗基础设施来实施癌症预防措施并提供基本癌症治疗,是改善和确保癌症控制及治疗结果公平性的关键。