Cancer survival in Africa, Asia, and Central America: a population-based study

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• 作者：Rengaswamy Sankaranarayanan ; Rajaraman Swaminathan ; Hermann Brenner ; Kexin Chen ; Kee Seng Chia ; Jian Guo Chen ; Stephen CK Law ; Yoon-Ok Ahn ; Yong Bing Xiang ; Balakrishna B Yeole ; Hai Rim Shin ; Viswanat
• 刊名：Lancet Oncology
• 出版年：2010
• 出版时间：February 2010
• 年：2010
• 卷：11
• 期：2
• 页码：165-173
• 全文大小：148 K

文摘

Summary

Background

Population-based cancer survival data, a key indicator for monitoring progress against cancer, are not widely available from countries in Africa, Asia, and Central America. The aim of this study is to describe and discuss cancer survival in these regions.

Methods

Survival analysis was done for 341 658 patients diagnosed with various cancers from 1990 to 2001 and followed up to 2003, from 25 population-based cancer registries in 12 countries in sub-Saharan Africa (The Gambia, Uganda), Central America (Costa Rica), and Asia (China, India, Pakistan, Philippines, Saudi Arabia, Singapore, South Korea, Thailand, Turkey). 5-year age-standardised relative survival (ASRS) and observed survival by clinical extent of disease were determined.

Findings

For cancers in which prognosis depends on stage at diagnosis, survival was highest in China, South Korea, Singapore, and Turkey and lowest in Uganda and The Gambia. 5-year ASRS ranged from 76–82 % for breast cancer, 63–79 % for cervical cancer, 71–78 % for bladder cancer, and 44–60 % for large-bowel cancers in China, Singapore, South Korea, and Turkey. Survival did not exceed 22 % for any cancer site in The Gambia; in Uganda, survival did not exceed 13 % for any cancer site except breast (46 % ). Variations in survival correlated with early detection initiatives and level of development of health services.

Interpretation

The wide variation in cancer survival between regions emphasises the need for urgent investments in improving awareness, population-based cancer registration, early detection programmes, health-services infrastructure, and human resources.

Funding

Association for International Cancer Research (AICR; St Andrews, UK), Association pour la Recherche sur le Cancer (ARC, Villejuif, France), and the Bill & Melinda Gates Foundation (Seattle, USA).