中西乳腺癌流行差异及其对防治的启示

Disparities of breast cancer burden between China and western countries and its implication

我国的乳腺癌负担正加速上升，其在全球所占的比重亦在增加。与西方发达国家发病上升趋缓、死亡率下降的形势不同，我国乳腺癌发病率和死亡率均呈明显上升趋势，乳腺癌的生存率也低于发达国家；城市和农村在乳腺癌发病、死亡和生存的现况和发展趋势方面的明显差异是我国乳腺癌疾病负担的重要特征。我们需要通过描述乳腺癌的疾病流行特征及其与西方发达国家的差异，以借鉴发达国家在乳腺癌预防、早期发现和筛查、诊断治疗、生存管理等各个领域积累的丰富证据和防治经验；并通过评估现有预防、诊治的循证证据，结合我国社会经济条件和人文环境，更好地规划我国的乳腺癌防治重点，实施各项防治措施，以应对未来我国乳腺癌防控方面所面临的挑战。

The disease burden of breast cancer in China is growing, and its proportion contributed to the global burden is increasing accordingly. The western countries have achieved reduction of mortality and slow growth of incidence, while the breast cancer incidence and mortality rates have been increasing constantly with lower survival rates in China. The remarkable characteristics of breast cancer burden in China is the disparities of the current status and time trends of incidence, mortality and survival between urban and rural area. The breast cancer disease distributions and time trends in China and the differential from the developed countries are described, which may be benefit to draw the international experience on prevention, early detection, medical care and survival management. Assessment of the existing evidence, elaboration of the prevention, control strategies in consideration of Chinese social-economic and culture situation would be beneficial to rise to the future challenge.