据英国《新科学家》杂志报道，一项全世界性研究表明，如果女士们生活在古巴，假如她们患有乳癌、结肠癌或直肠癌，那她们幸存的机会最大。相比之下，阿尔及利亚则是癌症患者的噩梦之地，是癌症死亡率最高的地方之一。此结论是科学家比较全球近200万癌症患者的生存率得出的。此结果发表在最新出版的《柳叶刀—肿瘤学》（The Lancet Oncology）杂志上。
通常情况下，生活在北美、西欧和其它发达国家的人比来自非洲、南美和东欧的人患上癌症后更能幸存下来。在美国，分析表明患癌症的黑人幸存机率比不上白人。比如，白人诊断出乳癌之后，其5年的存活率可达84.7%，而黑人的这一数字只有70.9%。白人与黑人之间的这一差异同样适合于美国的其它少数民族。不幸的是，纽约是美国癌症患者最糟糕的城市。
伦敦学院卫生与热带医学系的米歇尔·科尔曼及其世界各地的同事从五大州的31个国家收集了这些数据，分析了乳癌、前列腺癌和结肠直肠癌的得病情况，发现不同国家具有不同的死亡率，而其原因是多方面的，包括犯罪率、食物供应情况和饮水质量。因此，这一小组得出了“相对幸存率”，以尽量消除因这些因素所引起的差异。（生物谷Bioon.com）
生物谷推荐原始出处：
The Lancet Oncology，doi:10.1016/S1470-2045(08)70179-7，Michel P Coleman，John L Young
Cancer survival in five continents: a worldwide population-based study (CONCORD)
Prof Michel P Coleman FFPHa, , , Manuela Quaresma MSca, Franco Berrino MDb, Jean-Michel Lutz MDd, Roberta De Angelis BSce, Riccardo Capocaccia PhDe, Paolo Baili PhDc, Bernard Rachet MDa, Gemma Gatta MDb, Prof Timo Hakulinen PhDf, Andrea Micheli PhDc, Milena Sant MDb, Hannah K Weir PhDg, Prof J Mark Elwood MDh, Hideaki Tsukuma MDi, Sergio Koifman PhDj, Gulnar Azevedo e Silva PhDk, Silvia Francisci PhDe, Mariano Santaquilani PhDe, Arduino Verdecchia PhDe, Hans H Storm MDl, Prof John L Young PhDm and the CONCORD Working Group‡
aCancer Research UK Cancer Survival Group, Non-Communicable Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, London, UK
bDepartment of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
cDescriptive Epidemiology and Health Planning Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
dGeneva Cancer Registry, Geneva, Switzerland
eNational Centre for Epidemiology, Surveillance and Health Promotion, Department of Cancer Epidemiology, Istituto Superiore di Sanità, Rome, Italy
fFinnish Cancer Registry, Helsinki, Finland
gDivision of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
hBritish Columbia Cancer Agency, Vancouver, BC, Canada
iOsaka Cancer Registry, Department of Cancer Control and Statistics, Osaka Medical Centre for Cancer and Cardiovascular Diseases, Osaka, Japan
jDepartment of Epidemiology, National School of Public Health, Oswaldo Cruz Foundation, Ministry of Health, Rio de Janeiro, Brazil
kInstitute of Social Medicine, University of Rio de Janeiro, Rio de Janeiro, Brazil
lDepartment of Cancer Prevention and Documentation, Danish Cancer Society, Copenhagen, Denmark
mMetropolitan Atlanta SEER Registry, Georgia Center for Cancer Statistics, Department of Epidemiology, Rollins School of Public Health at Emory University, Atlanta, GA, USA
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Summary
Background
Cancer survival varies widely between countries. The CONCORD study provides survival estimates for 1·9 million adults (aged 15–99 years) diagnosed with a first, primary, invasive cancer of the breast (women), colon, rectum, or prostate during 1990–94 and followed up to 1999, by use of individual tumour records from 101 population-based cancer registries in 31 countries on five continents. This is, to our knowledge, the first worldwide analysis of cancer survival, with standard quality-control procedures and identical analytic methods for all datasets.
Methods
To compensate for wide international differences in general population (background) mortality by age, sex, country, region, calendar period, and (in the USA) ethnic origin, we estimated relative survival, the ratio of survival noted in the patients with cancer, and the survival that would have been expected had they been subject only to the background mortality rates. 2800 life tables were constructed. Survival estimates were also adjusted for differences in the age structure of populations of patients with cancer.
Findings
Global variation in cancer survival was very wide. 5-year relative survival for breast, colorectal, and prostate cancer was generally higher in North America, Australia, Japan, and northern, western, and southern Europe, and lower in Algeria, Brazil, and eastern Europe. CONCORD has provided the first opportunity to estimate cancer survival in 11 states in USA covered by the National Program of Cancer Registries (NPCR), and the study covers 42% of the US population, four-fold more than previously available. Cancer survival in black men and women was systematically and substantially lower than in white men and women in all 16 states and six metropolitan areas included. Relative survival for all ethnicities combined was 2–4% lower in states covered by NPCR than in areas covered by the Surveillance Epidemiology and End Results (SEER) Program. Age-standardised relative survival by use of the appropriate race-specific and state-specific life tables was up to 2% lower for breast cancer and up to 5% lower for prostate cancer than with the census-derived national life tables used by the SEER Program. These differences in population coverage and analytical method have both contributed to the survival deficit noted between Europe and the USA, from which only SEER data have been available until now.
Interpretation
Until now, direct comparisons of cancer survival between high-income and low-income countries have not generally been available. The information provided here might therefore be a useful stimulus for change. The findings should eventually facilitate joint assessment of international trends in incidence, survival, and mortality as indicators of cancer control.
Funding
Centers for Disease Control and Prevention (Atlanta, GA, USA), Department of Health (London, UK), Cancer Research UK (London, UK).
