2021-11-13-世界卫生组织-Explanatory_notes_for_2020_cancer_profiles_11页_5mb

报告摘要

Incidence & Mortality (2018/2019):
- Total cancer cases: High estimates based on WHO GHO database.
- Top cancers by incidence: Breast (16.7%), cervix uteri (9.3%), colorectum (8.6%).
- Top cancers by mortality: Lung (12.6%), breast (11.0%), leukaemia (5.5%).
Risk Factors:
- Population attributable fractions: Tobacco (5.1%, cancer deaths), alcohol (2.6%, cancer deaths), infections (24.1%, cancer cases), obesity (18.7%, cancer cases), UV exposure (0.3%, melanoma cases).
- High uncertainty in incidence estimates due to lack of population-based cancer registries; mortality data also uncertain without national NCD data.

Past & Future Trends:
- Breast and lung cancer cases and premature mortality probabilities have increased since 2000, with projections for continued growth through 2040.
- SDG target: Reduce premature cancer mortality by one-third by 2030 from 2015 baseline.
Probability of Premature Death: Based on age-specific death rates (ages 30–69), approximately 6.7% in 2018, expected to decrease with SDG alignment.

Costs & Lives Saved: Annual investment per capita ranges from $0.50 to $4.50, saving 5,000–60,000 lives annually. Return on investment high ($7 for every $1), focusing on essential services for non-communicable diseases and cancer.
Income Level: Reflects World Bank classification 2019; high-cost regions (MICs) are not included.
Methodology: Uses bottom-up costing for interventions, captured in "best buys" endorsed by WHO.

Registry & Registration: Population-based cancer registry unavailable (high uncertainty in incidence estimates). Mortality registration no coverage (based on 2007–2016 data).
Workforce & Equipment: Limited personnel; e.g., 0.1 external beam radiotherapists per 10,000 cancer patients; CT scanners: 5.0, MRI: 1.0, PET/CT: 0.0. Staff dedicated to cancer care noted, but 0.1 or fewer public cancer centers per 10,000 cancer patients.

Operational Plans: Integrated NCD plan and NCCP active (2019); MPOWER measures fully implemented (2018).
Screening & Prevention: Breast cancer screening program launched (starting age 40, <10% participation). Cervical cancer screening opportunistically with low participation.
Treatment Availability: Cancer management guidelines available; no bone marrow transplantation or advanced palliative care community options; pathology services generally unavailable.

Elimination Programs: HPV vaccination coverage at 0% (2018); cervical cancer screening available but participation low (<10%).
Childhood Cancer: Annual cases (0–14 years): 6,175; guided by global initiatives but limited data.
Data Sources: Provides references to WHO, IARC, and other databases for full details.

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