诊断时乳腺癌的全球阶段分布:系统性审查和元分析
Javier David Benitez Fuentes1,2,3, Eileen Morgan1, Alicia de Luna Aguilar2,3
1Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon.
JAMA oncology
|November 9, 2023
概括
全球乳腺癌的诊断阶段因地区和社会经济地位而异. 虽然转移性诊断总体上下降了,但差异仍然存在,这凸显了全球改善早期检测和癌症登记数据的必要性.
科学领域:
- 在瘤学瘤学.
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 诊断时的阶段是癌症生存的关键决定因素.
- 了解乳腺癌阶段的全球分布对于有针对性的干预措施至关重要.
研究的目的:
- 分析全球乳腺癌诊断阶段的变化.
- 检查国家,年龄,时间段和社会经济地位如何影响诊断阶段.
主要方法:
- 在 MEDLINE,科学网络和灰色文学 (2000-2022) 的系统文献搜索.
- 包括以人口为基础的癌症注册数据用于原发性乳腺癌.
- 提取和合成特定阶段比例,并进行质量和偏差评估.
主要成果:
- 来自81个国家的240万名妇女的数据显示,撒哈拉以南非洲 (5.6%-30.6%) 与北美 (0.0%-6.0%) 的偏远转移性乳腺癌发病率较高.
- 在20多年中,远程转移性诊断的总体下降被观察到,但区域差异和一些稳定或增加.
- 高龄和较低的社会经济地位与更高比例的远程转移性诊断有关.
结论:
- 有效的政策在高收入国家减少了转移性乳腺癌的诊断,但不平等仍然存在.
- 解决差异需要提高公众对症状的认识和早期检测策略.
- 改善全球癌症注册表覆盖率和数据标准化对于监测进展至关重要.
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