Release date: 2014-11-11
The 5-year survival rate of all cancers in China is 30.9% (after age standardization), far lower than that of developed countries. This is because there are differences in the types of cancer that everyone suffers. The incidence of cancer in China is lower than in Europe and America, but the mortality rate is much higher.
First: contrary to Europe and the United States, most of the cancers with high incidence in China are “not easy to cureâ€.
There are many types of cancer, such as lung cancer, stomach cancer, prostate cancer, and breast cancer. But don't talk about cancer. Some cancers are "good governance", and the survival rate is very high. Some cancers are "not easy to cure", and patients hope to survive.
What cancer is "good governance"? Breast cancer, prostate cancer, etc. are listed here. For example, not long ago, the authoritative medical journal New England Medicine published a new study that believes that prostate cancer does not require early screening because it is slow and is an "inert" cancer, and in most cases does not affect the life expectancy of patients. The current screening methods have great drawbacks. In Europe and the United States, breast cancer and prostate cancer are major cancers, so although the incidence of cancer in Europe and the United States is higher than in developing countries, the mortality rate is much lower.
The situation in China is the opposite. According to the 2013 Annual Cancer Registration Report, lung cancer, stomach cancer, liver cancer, esophageal cancer, and colorectal cancer are the most common tumors in men, accounting for more than 70% of all cases; breast cancer, lung cancer, colorectal cancer, and stomach cancer in women. The most common tumors of liver cancer account for more than 60% of all cases. Lung cancer, stomach cancer, liver cancer, and esophageal cancer are all "bad" cancers, and the survival rate is not high worldwide. For example, lung cancer, the 5-year survival rate between China and the United States is not much different, the United States is 16.8% (test data from the National Cancer Institute), China is 16.1% (large-scale statistics from the National Cancer Research Office of China Cancer Center) ).
Second: the cancer rate of "good governance" in China is not as good as that of Europe.
Among China's high-risk cancers, breast cancer and colorectal cancer are also relatively "good". For example, breast cancer, the 5-year survival rate in China is 73%, which is much better than the 16.1% lung cancer 5-year survival rate. However, it is far worse than the European and American countries. According to a paper published by the National Cancer Center in the journal International Cancer Research, the United States is 90%, Australia is 89%, and Europe is 82%. Colorectal cancer is also a similar situation.
"Poor cancer" has not gone: In addition to lung cancer, China's high-risk "difficult cancer" is a "traditional retention project"
According to the International Cancer Agency's data on new cancers in 2012, 83% of newly discovered liver cancers in the world are in developing countries, half of which are in China; more than 70% of newly discovered gastric cancers are in developing countries, and half of them are in East Asia (mainly In China); more than 80% of esophageal cancers and 85% of cervical cancers are found in underdeveloped areas, with East Asia and Africa being the hardest hit areas. Obviously, difficult cancers such as liver cancer, stomach cancer, esophageal cancer, and cervical cancer seem to be particularly "prone to poverty." Therefore, some scholars call these cancers "poor cancer."
Why is “poor cancer†keen to find underdeveloped areas? This is closely related to infectious factors and public health. According to authoritative sources from the World Health Organization, one in five cancers worldwide is caused by chronic infections, such as cervical cancer caused by human papillomavirus and liver cancer caused by hepatitis B virus. Economically developed countries have the energy and money to deal with these viruses through public health policies, and the situation will naturally be much better than in developing countries. Although China has made great progress in the prevention of hepatitis B, there is too much historical debt. As it enters an aging society, the high incidence of liver cancer continues.
"Fever cancer" is again: lung cancer is the first, and "rich cancer" such as breast cancer and colorectal cancer is coming.
Lung cancer is the world's number one cancer killer and the most deadly cancer in China today. Its incidence in China can be described as soaring – the third survey of death causes shows that lung cancer mortality has increased by 465% over the past 30 years, replacing liver cancer as the most common malignant tumor in China. What is the relationship between lung cancer and smoking, air pollution and other factors, so lung cancer is also high in developed countries in Europe and America.
Breast cancer and colorectal cancer are also called "rich cancers." According to the International Cancer Agency, the top three regions with the highest incidence rate are Western Europe, North America, and Northern Europe; the latter are Australia, Western Europe, and Southern Europe. These two types of cancer have also been on the rise in China in recent years, and scholars at home and abroad have predicted that their incidence will be higher and higher in China. Breast cancer is already the most common cancer among Chinese women. Why is this? Originally, "rich cancer" is generally related to eating habits and lifestyles, eating more and more "good", moving less and less, and the risk of suffering from these "rich cancers" is coming. The bigger it is. In the case of breast cancer, the World Health Organization reported that the incidence of breast cancer in some Southeast Asian countries and African countries is five times lower than in developed countries. Dr. Tim Key, an epidemiologist and cancer expert at the University of Oxford, said: "It cannot be said that there are people who are genetically immune to the disease because we know that if people migrate from poor countries to rich countries, their incidence after one or two generations. It’s the same as Westerners. It’s about people’s lifestyles.â€
"Poverty cancer" kills "rich cancer" and has to learn public health policy from developed countries
In April this year, an important report published by The Lancet Oncology said that 29.4% of cancer deaths in China were related to chronic infections, and 22.6% were related to smoking. Therefore, it is very important to deal with chronic infection by means of vaccines, water purification, etc., to control lung cancer. Less “poor cancer†in developed countries is also associated with good public health policies.
As mentioned above, the current hepatitis B vaccine in China has achieved very good results, but the incidence of liver cancer is still high because of the large population base and aging. However, cervical cancer, which can be directly controlled by vaccines, does not receive such good “treatmentâ€. Today's topic "Celiac cancer vaccine dystocia, pseudo-vegetable cervical erosion" has already raised this point: "Cervical cancer is the second most common female cancer in the world, and China has a new incidence of up to 130,000 a year. Cervical cancer is a vaccine that can be prevented. Cancer, vaccination can effectively prevent 70% of cervical cancer." However, "cervical cancer vaccine has been promoted in more than 160 countries and regions around the world, but it is still difficult to produce in mainland China." The reason is that the vaccine is still in lengthy approval, and this approval process has been 8 years. So many young women with strong health awareness can only go to Hong Kong and even go to Southeast Asia to vaccinate.
In addition to vaccines, water is also vital. Last year, the long-term research results of the China CDC expert team published the "Atlas of Water Environment and Digestive Cancer Tumors in the Huaihe River Basin", which confirmed the direct relationship between high incidence of cancer in the digestive tract and water pollution. Gastrointestinal cancer such as gastric cancer and esophageal cancer are traditional Chinese “poor cancersâ€.
Of course, there is also tobacco control. Whether you have money or no money, lung cancer is an absolute killer. By controlling tobacco, the incidence of lung cancer can be effectively reduced. In recent years, the incidence of lung cancer in the United States has shown a downward trend, which is considered to be effective in tobacco control.
Effective tobacco control policies are important to reduce the incidence of lung cancer, and lung cancer is high in the world.
Breast cancer and colon cancer can be detected early by screening physical examination, and once found, better control can be obtained. This is far more complicated than finding it in the middle and late stages, and then it is much better and more costly to carry out various "overtreatments". According to the official report of the World Health Organization, “although some risks may be reduced through prevention, this strategy cannot eliminate most breast cancers formed in low- and middle-income countries. Therefore, early detection to improve breast cancer outcomes and survival The rate is still the cornerstone of breast cancer control."
Since breast cancer is the largest cancer among Chinese women, the need for public health policy for early screening is obvious. In fact, starting in 2009, the former Ministry of Health and the All-China Women’s Federation began to carry out women’s “two cancers†(ie cervical cancer and breast cancer) screening projects in rural areas. In 2013, such pilot projects were extended to cities. However, the method is wrong. Some experts say that "the method of hand-diagnosis in breast cancer screening is to use a doctor's hand to check the diagnosis. The efficiency is low, and the rate of misdiagnosis is very unreasonable. It is very unreasonable." Instead, they are criticized for wasting public health resources and may bring unnecessary “everyone’s self-defenseâ€. Many relevant people also pointed out that China does not have so much money to bear the inspection of high conditions. How can we implement an economic and effective cancer screening public health policy? Today, more and more “rich cancer patients†must be discussed and valued.
Source: Tencent Review
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