The three major authorities released the latest version of the World Cancer Atlas, and China was named again?

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On October 16, the new “Atlas of Cancer” was released at the World Cancer Leaders Summit in Nursultan, Kazakhstan.The third edition of the Cancer Atlas provides a comprehensive overview of the basics of cancer worldwide, highlighting the current state of the world’s cancers and its underlying causes, as well as successful strategies to alleviate the cancer burden in all countries.The Cancer Atlas is produced by the International Organization for Research on Cancer (IARC), a specialized cancer agency of the World Health Organization, in collaboration with the American Cancer Society (ACS) and the International Union for Cancer Control (UICC).After a comprehensive overview of cancer worldwide, the researchers concluded that progress in combating cancer is not only possible but achievable.Overview Cancer is a major public health burden and economic issue.There were 18.1 million new cases of cancer in 2018, and 9.6 million people died of cancer; on average, 1 out of every 4 men and 1 in 5 women will develop cancer; an average of 1 out of every 8 menOne out of every 11 women will die of cancer.In addition, 43.8 million people were diagnosed with cancer in the past 5 years in 2018.Half of the world’s new cancer cases and deaths occur in Asia, as shown in Figure 1.China is the world’s largest number of new cases (4.3 million cases, accounting for 24% of the total) and deaths (2.9 million cases, accounting for 30% of the total).On the whole, lung cancer is the most common cancer in the world.There were 2.1 million new cases in 2018, accounting for 12% of the total; it is also the leading cause of cancer deaths (1.8 million cases, 18% of the total) because of its poor prognosis.The areas with the highest incidence of lung cancer in men are Europe (especially Eastern Europe), as well as Asian countries such as Turkey and China.Historically, men’s lung cancer mortality has been higher than that of women due to large amounts of smoking.Female breast cancer is the second most common cancer, with 2.1 million new cases in 2018, accounting for 12% of the total; it is the fifth leading cause of cancer deaths (627,000 cases, 7% of the total).Because of its relatively good prognosis, 6.9 million women survived within 5 years after being diagnosed with breast cancer.Colorectal cancer is the third-highest cancer in the world (1.8 million cases), but it is second only to lung cancer in the mortality rate (881,000 cases).Prostate cancer is the fourth most commonly diagnosed cancer, and gastric cancer and liver cancer remain the leading causes of cancer deaths in 2018.Based on projected population growth and aging trends, the global cancer burden is expected to increase by 62% in 2040 (from 18.1 million in 2018 to 29.4 million in 2040); as shown in Figure 2.A wider range of lifestyle factors, such as smoking, unhealthy diets and lack of physical activity, may increase this number significantly.In the past few decades, cancer has become the leading cause of death in the global population.In the case of premature death (defined as death between the ages of 30 and 69), cancer was the leading cause of death in 55 countries (mostly high-income countries) in 2016, and the death toll in another 79 countries.The reason (mainly due to cardiovascular disease) is shown in Figure 3.Due to the high level of success in prevention and treatment strategies, cardiovascular mortality has declined in many countries, and cancer will be a major obstacle to the increase in life expectancy in this century.What is the performance of Asian countries?China is still being named?In 2018, 8.2 million new cancer cases and 5.2 million cancer deaths occurred in South Asia, East Asia and Southeast Asia, equivalent to half of the world’s cancer burden.China alone accounts for 52% (4.3 million) of new cancer cases in the region and 55% (2.9 million) of cancer deaths.Overall, lung cancer (1,166,200 new cases, accounting for 15% of all cases), colorectal cancer (914,200 cases, 11%) and female breast cancer (845,400 cases, 10%)) is the most common cancer in this area.Lung cancer remains the leading cause of death (1,013,100 deaths, 21% of the total), followed by gastric cancer (560,500 deaths, 11%) and liver cancer (554,000, 11%).The incidence of cancer in the region varies widely, with almost four-fold differences between countries, as shown in Figure 4.The incidence rate in Southeast Asia is higher, and the overall incidence rate in Korea is the highest (314 cases per 100,000 population).In contrast, some countries in South Asia (including Bhutan, Sri Lanka and India) have a lower incidence.Mortality patterns across regions have also shown similar patterns: Mongolia (170 per 100,000 people) and China (130 per 100,000 people) have the highest mortality rates, while Sri Lanka (51 cases) and India (61 cases)The mortality rate is the lowest.Breast cancer is the most common cancer in women in almost all Asian countries, but there are significant differences in men.For example, oral cancer is the most common cancer in men in most South and Southeast Asian countries, while in East Asia, liver cancer and gastric cancer are more common in men and the leading cause of death from men due to cancer.The third edition of the Cancer Atlas. Other highlights of tobacco harm The largest number of preventable cancer deaths caused by smoking is more than any other risk factor.It is estimated that in 2017 alone, 2.3 million people worldwide died from smoking, accounting for 24% of all cancer deaths; another 190,000 cancer patients died of smokeless tobacco (referring to various non-smoke tobacco products,Such as snuff, impregnated tobacco and chewing tobacco) and secondhand smoke.Although lung cancer is the most common cancer caused by smoking, at least 19 other cancers (such as cervical cancer, pancreatic cancer, and colorectal cancer) have a causal relationship with smoking.There are still 1.1 billion smokers in the world, 80% of whom live in low- and middle-income countries.In the past decade, advances in tobacco control legislation have meant that 1.5 billion people in 55 countries are now protected by smoke-free legislation.Infectious pathogens are also murderer infectious agents that cause many types of cancer (as shown in Figure 6), although it accounts for about 15% of all new cancer cases worldwide, but this proportion is from very high-income countries.About 4% of them go to more than 50% of some sub-Saharan African countries.Helicobacter pylori (Hp), human papillomavirus (HPV), hepatitis B virus (HBV) and hepatitis C virus (HCV) are the four most important infectious agents (more than 90% of all infection-related cancers)).Among them, Hp caused 90% of gastric cancer, and half of it occurred in China.Weight loss – it’s easier said than done, it’s hard to overweight and increases the risk of 13 cancers. In 2012, it accounted for 3.6% of new cancer cases in adults worldwide.The prevalence of overweight worldwide is rising: in 2016, 39% of men and 40% of women aged 18 and over were obese; 27% of boys between the ages of 5 and 18 wereAnd 24% of girls are obese.Drinking a lot of sugary drinks and sedentary behavior (including watching TV and computer screens for a long time) increases the risk of being overweight.Due to the prevalence of obesity, the cancer burden associated with unhealthy diets, overweight and lack of physical activity is expected to increase in most parts of the world, particularly in parts of the Middle East and several other low- and middle-income countries in Asia and Oceania.Wine – don’t be afraid of getting cancer, you can drink!Drinking alcohol can cause oral cancer, throat cancer, esophageal cancer, liver cancer, colon cancer, rectal cancer, and female breast cancer.In 2016, 4.2% of global cancer deaths were attributable to drinking, and there were significant differences between countries.Breast cancer – a lingering pain in women’s minds Breast cancer is the most common cancer among women in almost every country in the world, accounting for nearly a quarter of new cancer cases in women. In 2018, breast cancer is the world’s mostNational cancer is the most commonly diagnosed cancer.About one in every 20 women will be diagnosed with breast cancer in their lifetime, although this percentage varies from country to country.Women in high-income countries are three times more likely to develop breast cancer in their lifetime than women in low-income countries.However, in high-income countries, if breastfeeding time is increased from the current duration to 12 months per child, in low- and middle-income countries extended to 2 years, 22,000 breast cancer deaths can be avoided each year.In the next half century, if the current trend continues, it is estimated that 44 million cervical cancers will occur worldwide.Effective high-screen screening and vaccination can avoid more than 13 million cervical cancers by 2069 and eventually lead to the eradication of this gynaecological cancer, lest it become a major public health problem.Indoor and outdoor air pollution also complicates outdoor air pollution, killing more than 500,000 lung cancer patients each year, and millions of people dying from other diseases.In cities with rapid development in low- and middle-income countries, outdoor air pollution levels are particularly high.Diesel exhaust is classified as a lung carcinogen by IARC and is one of the main causes of outdoor air pollution. It is also an occupational lung carcinogen.Indoor air pollution caused by the use of solid fuels such as firewood and coal causes approximately 3.8 million deaths in low- and middle-income countries each year, including approximately 285,000 lung cancer deaths.Globally, although the number of people cooking with solid fuels has declined, the population of less developed countries still faces serious indoor air pollution.About 3% to 6% of cancers worldwide are caused by exposure to carcinogens in the workplace.Asbestos is an important cause of occupational lung cancer.Children and adolescents are also victims worldwide. The average annual incidence of cancer among children under 15 is 140 new cases per million children, but there are large differences between regions and races (maximum gaps up to 3The most common cancers in children are leukemia, lymphoma, central nervous system tumors, sympathetic nervous system tumors and soft tissue sarcomas.Lymphoma or germ cell tumors are the most common cancer among adolescents aged 15-19 years, and the overall incidence has risen to 185 per million people.In contrast, the incidence of adolescent embryonal tumors such as neuroblastoma, retinoblastoma, and nephroblastoma is very low.High doses of ionizing radiation, birth weight and certain genetic syndromes are associated with increased risk of cancer in children and adolescents.In high-income countries, more than 80% of childhood cancer patients survive 5 years after diagnosis; in contrast, in low-income countries, this percentage is as low as 20% because their treatment opportunities are not ideal and the diagnosis is late.And the family’s economic burden is heavy.Under the interventions to improve early diagnosis and adherence to correct treatment, childhood cancer survival rates in low-income countries can be increased to 60%, saving nearly 1 million children in a decade.There are significant regional differences in radiotherapy. About 60% of cancer patients receive radiation therapy to relieve symptoms, shrink tumors before surgery, or kill residual cancer cells after surgery to avoid recurrence.In many low- and middle-income countries, radiotherapy coverage is below optimal levels.For example, although Ethiopia has more than 100 million people, there is only one radiotherapy center in the country.The relationship between cancer and the Human Development Index Over the past century, the decline in infectious disease mortality, child and maternal mortality, and fertility rates have led to rapid population growth and aging, which has increasedThe burden of infectious diseases.If the Human Development Index (the United Nations Development Programme’s Human Development Report 1990), the indicator used to measure the level of economic and social development of the UN member states, the English abbreviation (HDI) is used as a measure, as countries experience significantIn transition, the scale of cancer problems worldwide continues to expand.Cancer is a major cause of premature death (age <70 years) associated with socioeconomic transformation.Cancer is the leading cause of premature death in 48 countries (mainly countries with high HDI), surpassing cardiovascular disease.For example, in Japan, cancer accounts for 45% of all premature deaths, and cardiovascular disease accounts for 21%.In another 43 countries, cancer is the second leading cause of premature death after cardiovascular disease, and these two diseases are ranked lower in the prevalence of early death in most countries with low HDI levels.For example, in South Africa, infectious and parasitic diseases account for 45% of premature deaths, while cancer and cardiovascular disease each account for 10%.Survivors' conditions are not optimistic The number of cancer survivors worldwide is increasing, driven by early detection, advances in treatment, and an aging population.In 2018, there were 43.8 million cancer survivors diagnosed in the past five years.Although some cancer survivors have survived, the life after diagnosis has brought them severe and lasting challenges.Fear of recurrence, depression, pain, memory loss, sexual dysfunction, interpersonal problems, and concerns about schooling are common problems.Late effects (occurring months or years after treatment) may include heart problems, lymphedema, impaired function, and secondary cancer.The combination of long-term and late-stage effects of cancer doubles the risk of survivors' decline in quality of life associated with mental and physical health.Cancer survivors of working age often face challenges in maintaining employment.They either have difficulty paying for medical bills or postpone or give up treatment because they are too expensive.Most of the elderly cancer patients have one or more comorbidities.What should I do if I feel hurt?For cancer-caused pain, the list of essential medicines in the World Health Organization and many countries includes opioid analgesics such as morphine.About 80% of patients with advanced cancer have moderate to severe pain and cannot be relieved without taking painkillers.However, millions of cancer patients (almost entirely from low- and middle-income countries) lack basic painkillers.Cancer patients who die from pain without treatment are mainly distributed in East Asia and the Pacific, South Asia, and sub-Saharan Africa.Legal and regulatory restrictions, cultural misunderstandings of pain, inadequate training of medical staff, poor market operations, weak health systems, and concerns about the use of addictive drugs have led to limited access to painkillers.Morphine is actually the most effective treatment for severe pain and is a safe, effective, inexpensive and easy to use means.How to take anti-cancer and anti-cancer actions?The use of adequate and effective interventions can significantly reduce cancer-related morbidity and mortality.From the prevention of risk factors to early detection, treatment, survival and hospice care, each country should adopt cancer prevention and control measures appropriate to the national conditions.In order to reduce the cancer caused by smoking, governments should substantially increase the consumption tax on tobacco, implement a law prohibiting smoking in public places, force health warnings on cigarette packages, and impose strict restrictions on tobacco promotion and advertising.For unhealthy diets and lack of exercise-induced cancer, public awareness of their health hazards should be raised, consumption tax should be imposed on sugar-sweetened beverages, and places that are easy for people to create activities (such as fitness equipment in the community, additional walking and cycling trails).Since HBV and HPV are infectious pathogens that cause liver cancer and cervical cancer and other urinary, reproductive, and oropharyngeal cancers, these cancers can be prevented by vaccination.For example, if 70% of eligible girls are vaccinated against cervical cancer, it is estimated that 178,000 cervical cancer deaths can be avoided each year worldwide.. Cancer caused by indoor and outdoor air pollution can be reduced through the use of clean stoves, clean fuels, proper ventilation, and the promulgation and implementation of air quality guidelines and policies.By increasing workplace safety, occupational exposures that cause cancer can be reduced.Regular screening for cervical cancer, colorectal cancer, breast cancer, and lung cancer can be found early; because of the better treatment of these cancers, the chances of survival and cure are high. , please do not reprint without the authorization of the copyright owner.


The author ouyangshaoxia