全球癌症热点图：患癌负担转至发展中国家

The global burden of cancer is shifting dramatically. Once considered a disease of the wealthy, it now has a significant impact in every region, and the greatest proportional increases in cases in the coming years are predicted to be in the poorest corners of the world. Worldwide, an estimated 14.1 million new cancer cases were diagnosed in 2012 and 8.2 million cancer deaths.

全球的癌症负担有了巨大转变。以前人们把癌症视为“富人病”，现在这种病却给全球带来了巨大影响。未来几年中，患癌比例的最高增幅预计会出现在世界上最穷的地区。2012年全球新增癌症病例约1410万例，死亡患者达820万人。

In an analysis that maps the world's hot spots for cancer, epidemiologist Lindsey Torre found a tremendous heterogeneity in which forms of the disease are most commonly diagnosed in different countries.

在全球癌症热点分布图中，流行病学家林德赛·托尔发现了一种极不均匀的分布特点——各国常患癌症的类型各不相同。

Among the most significant trends they identified is a growing inequality between high-income countries and lower-income countries in cancer diagnoses — with cancer rates declining in high-income countries but rising in lower-income countries.

他们发现，最突出的一个趋势便是高收入国家和低收入国家在患癌率上越来越不均衡——高收入国家的癌症患病率下降，而低收入国家的癌症患病率上升。

The difference is especially striking in lung, colorectal and breast cancer. Better screening, early detection and access to treatment plus a decrease in risk factors like smoking probably explain part of the positive trend among the high-income countries.

其中，以肺癌、结肠癌和乳腺癌的差距尤甚。或许更好的筛查条件、早发现早治疗以及类似吸烟等诱因的减少能解释高收入国家癌症患病率下降的原因。

As for the rising cancer rates in lower-income countries, "it's related to the adoption of a Western lifestyle," Torre explained in an interview. "People are less active," she said. "There is less manual labor and more use of transport. They have access to perhaps more appealing but less healthy foods."

托尔在一次采访中说道，至于低收入国家的癌症患病率为什么越来越高，“或许是与采用西方的生活方式有关。”他说道，“人们的运动越来越少。体力劳动减少，交通工具的使用增多，人们还可以吃到更美味但并不是那么健康的食物。”

Developing countries also bear a disproportionate burden of infection-related cancers related to the stomach bug helicobacter pylori, hepatitis and human papillomavirus (HPV)‎.

在幽门螺杆菌、肝炎和人乳头瘤病毒（HPV）等能致使肠胃细菌感染的感染性相关癌症上，发展中国家的负担也并不均衡。

Addressing this inequality is critical, the researchers wrote in the journal Cancer Epidemiology, Biomarkers Prevention, because "a large proportion of cancers can be prevented through measures including tobacco control, vaccination, early detection, and promotion of healthy lifestyles."

研究人员在期刊《癌症流行病学、生物标记及预防》上写道，解决不均衡现象至关重要，因为“采取预防措施能大幅减少癌症患病率，比如控烟、接种疫苗、及早发现和推广健康的生活方式。”

"In addition, the burden of suffering can be reduced through appropriate treatment and palliative care. To apply these cancer control measures equitably around the world, a concerted effort will be required not only from individual country governments but also from international agencies, donors, civil society," they said.

他们还说道，“此外，患病的痛苦也可以通过适当的治疗和姑息护理得到减缓。要想在全球范围内均衡地推广这些管控手段，不仅需要各国政府的齐心协力，国际机构、捐赠者和公民社会也要倾力合作。”

Torre and her colleagues at the American Cancer Society analyzed incidence and mortality data for 2003-2007 from the International Agency for Research on Cancer databases and mortality data from the World Health Organization through 2012. They selected 50 countries selected to represent various regions of the world and focused on eight major cancers.

托尔和来自美国癌症学会的几位同事分析了国际癌症研究机构的数据库中，2003年-2007年癌症患者的发病率和死亡率，还研究了世界卫生组织2012年的死亡率数据。他们选出50个分布在世界各地的国家，并着手调查这些国家中八种主要癌症的发病情况。

Among males, prostate cancer is the most commonly diagnosed cancer in most countries, with the exception of those in Eastern Europe where lung cancer is the No. 1 cancer. Among females, breast cancer is the most common among those in North America, Europe and Oceania. There's more diversity in Asia, where lung cancer ranks first in China and North Korea, liver in Laos and Mongolia and thyroid in South Korea.

男性中，大多数国家最常确诊的癌症是前列腺癌，但东欧地区发病率最高的却是肺癌。女性中，北美、欧洲和大洋洲发病率最高的是乳腺癌。亚洲癌症发病的类型较多，中国和朝鲜排名第一的癌症是肺癌，老挝和蒙古则是肝癌，韩国是甲状腺癌。

Vocabulary

heterogeneity: 不均匀性

colorectal: 结肠直肠的

palliative care: 姑息治疗，临终关怀

thyroid: 甲状腺