Premature mortality trends in 183 countries by cancer type, sex, WHO region, and World Bank income level in 2000-19: a retrospective, cross-sectional, population-based study.

IF 41.6 1区 医学 Q1 ONCOLOGY Lancet Oncology Pub Date : 2024-08-01 Epub Date: 2024-07-01 DOI:10.1016/S1470-2045(24)00274-2
Shilpa S Murthy, Dario Trapani, Bochen Cao, Freddie Bray, Shashanka Murthy, Thomas Peter Kingham, Chandrakanth Are, André M Ilbawi
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Abstract

Background: Cancer is a leading cause of mortality worldwide. By 2040, over 30 million new cancers are predicted, with the greatest cancer burden in low-income countries. In 2015, the UN passed the Sustainable Development Goal 3.4 (SDG 3.4) to tackle the rising burden of non-communicable diseases, which calls for a reduction by a third in premature mortality from non-communicable diseases, including cancer, by 2030. However, there is a paucity of data on premature mortality rates by cancer type. In this study, we examine annual rates of change for cancer-specific premature mortality and classify whether countries are on track to reach SDG 3.4 targets.

Methods: This is a retrospective, cross-sectional, population-based study investigating premature mortality trends from 2000-19 using the WHO Global Health Estimates data. All cancers combined and thirteen individual cancers in 183 countries were examined by WHO region, World Bank income level, and sex. The risk of premature mortality was calculated for ages 30-69 years, independent of other competing causes of death, using standard life table methods. The primary objective was to compute average annual rate of change in premature mortality from 2000 to 2019. Secondary objectives assessed whether this annual rate of change would be sufficient to reach SDG 3.4. targets for premature mortality by 2030.

Findings: This study was conducted using data retrieved for the years 2000-19. Premature mortality rates decreased in 138 (75%) of 183 countries across all World Bank income levels and WHO regions, however only eight (4%) countries are likely to meet the SDG 3.4 targets for all cancers combined. Cancers where early detection strategies exist, such as breast and colorectal cancer, have higher declining premature mortality rates in high-income countries (breast cancer 48 [89%] of 54 and colorectal cancer 45 [83%]) than in low-income countries (seven [24%] of 29 and four [14%]). Cancers with primary prevention programmes, such as cervical cancer, have more countries with declining premature mortality rates (high-income countries 50 [93%] of 54 and low-income countries 26 [90%] of 29). Sex-related disparities in premature mortality rates vary across WHO regions, World Bank income groups, and by cancer type.

Interpretation: There is a greater reduction in premature mortality for all cancers combined and for individual cancer types in high-income countries compared with lower-middle-income and low-income countries. However, most countries will not reach the SDG 3.4 target. Cancers with early detection strategies in place, such as breast and colorectal cancers, are performing poorly in premature mortality compared with cancers with primary prevention measures, such as cervical cancer. Investments toward prevention, early detection, and treatment can potentially accelerate declines in premature mortality.

Funding: WHO.

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2000-19 年 183 个国家按癌症类型、性别、世卫组织地区和世界银行收入水平分列的过早死亡率趋势:一项基于人口的回顾性横断面研究。
背景:癌症是全球死亡的主要原因。到 2040 年,预计将新增 3000 多万癌症患者,其中低收入国家的癌症负担最重。2015 年,联合国通过了可持续发展目标 3.4(SDG 3.4),以应对日益加重的非传染性疾病负担,该目标要求到 2030 年将包括癌症在内的非传染性疾病的过早死亡率降低三分之一。然而,按癌症类型划分的过早死亡率数据却很少。在本研究中,我们研究了癌症特定过早死亡率的年度变化率,并对各国是否有望实现可持续发展目标 3.4 的具体目标进行了分类:这是一项以人口为基础的回顾性横断面研究,利用世界卫生组织全球健康估计数据调查了 2000-19 年间的过早死亡率趋势。按世卫组织地区、世界银行收入水平和性别对 183 个国家的所有癌症和 13 种单项癌症进行了研究。采用标准生命表方法计算了 30-69 岁年龄段的过早死亡风险,与其他竞争性死因无关。首要目标是计算 2000 年至 2019 年过早死亡率的年均变化率。次要目标是评估这一年均变化率是否足以在 2030 年前实现可持续发展目标 3.4 中关于过早死亡率的目标:这项研究使用了 2000-19 年的数据。在世界银行所有收入水平和世界卫生组织所有地区的 183 个国家中,有 138 个国家(75%)的过早死亡率有所下降,但只有 8 个国家(4%)有可能在所有癌症方面实现可持续发展目标 3.4 的具体目标。乳腺癌和结肠直肠癌等有早期检测战略的癌症在高收入国家的过早死亡率下降率(54 个国家中有 48 个国家的乳腺癌死亡率下降[89%],45 个国家的结肠直肠癌死亡率下降[83%])高于低收入国家(29 个国家中有 7 个国家的乳腺癌死亡率下降[24%],4 个国家的结肠直肠癌死亡率下降[14%])。有初级预防计划的癌症,如宫颈癌,过早死亡率下降的国家较多(54 个国家中有 50 个高收入国家[93%],29 个国家中有 26 个低收入国家[90%])。过早死亡率与性别有关的差异在世界卫生组织各地区、世界银行各收入组别以及癌症类型中均有所不同:解释:与中低收入国家和低收入国家相比,高收入国家所有癌症和个别癌症类型的过早死亡率下降幅度更大。然而,大多数国家将无法实现可持续发展目标 3.4 的具体目标。与宫颈癌等有初级预防措施的癌症相比,乳腺癌和结直肠癌等有早期检测策略的癌症在过早死亡率方面表现较差。对预防、早期发现和治疗的投资有可能加速降低过早死亡率:世界卫生组织。
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来源期刊
Lancet Oncology
Lancet Oncology 医学-肿瘤学
CiteScore
62.10
自引率
1.00%
发文量
913
审稿时长
3-8 weeks
期刊介绍: The Lancet Oncology is a trusted international journal that addresses various topics in clinical practice, health policy, and global oncology. It covers a wide range of cancer types, including breast, endocrine system, gastrointestinal, genitourinary, gynaecological, haematological, head and neck, neurooncology, paediatric, thoracic, sarcoma, and skin cancers. Additionally, it includes articles on epidemiology, cancer prevention and control, supportive care, imaging, and health-care systems. The journal has an Impact Factor of 51.1, making it the leading clinical oncology research journal worldwide. It publishes different types of articles, such as Articles, Reviews, Policy Reviews, Personal Views, Clinical Pictures, Comments, Correspondence, News, and Perspectives. The Lancet Oncology also collaborates with societies, governments, NGOs, and academic centers to publish Series and Commissions that aim to drive positive changes in clinical practice and health policy in areas of global oncology that require attention.
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