Global cancer survival up, but progress uneven: study

台3癌症存活率 較他國低

【國際中心】一項跨國研究指出，癌症在不同國家接受治療，存活率差別很大，顯示各國醫療資源差異。這項研究也指出，相較其他地區，台灣的黑色素瘤、淋巴惡性腫瘤和骨髓惡性腫瘤患者存活率較低。
這項跨國研究收集自二○○○年至二○一四年間，七十一國、三千七百五十萬名癌症病患相關資料，發現全球癌症存活率都升高，在美、加、澳、紐、芬蘭等國，大部分癌症患者存活率都有九成，而部分國家的同樣癌症，病患五年存活率卻低很多。論文發表於前天出刊的《刺胳針》醫學期刊，主要作者是倫敦熱帶醫學院學者艾勒曼尼（Claudia Allemani）。

反映醫療品質

報告中提及，以兒童腦瘤為例，病患的五年存活率已從五成四升高到超過六成，美國、丹麥、瑞典、斯洛伐克高於八成，但在墨西哥和巴西，存活率不到四成。論文指，這些差異反映診斷和醫療服務的普及與品質。
在報告中，台灣的東亞黑色素瘤、淋巴惡性腫瘤和骨髓惡性腫瘤五年存活率分別為百分之五十二點一、百分之五十點五及百分之三十三點四，跟其他地區相比較低。
研究也提到，台、日、韓過去胃癌與食道癌機率較高，政府與企業年度健檢時較注意這方面篩檢，跟其他地區相比，亞洲對抗胃癌較為成功。 

Global cancer survival up, but progress uneven: study

AFP-JIJI, STAFF REPORT

• JAN 31, 2018
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PARIS – Cancer survival is increasing across the world but large gaps endure between nations, while some cancers remain hard to treat everywhere, according to a major review released Wednesday.

In Japan, the five-year lung cancer survival rate went from 23 to 33 percent, among the biggest improvements worldwide. The country also boasted the highest survival rate for esophageal cancer, at 36 percent.

Globally, progress and the gap between nations are especially large for childhood cancers, according to the Concord-3 study covering 71 nations and 18 types of cancer, published in the medical journal The Lancet.

For children with brain tumors, for example, five-year survival has improved across the board from 54 percent for the period 2000-2004, to more than 60 percent for 2010-2014.

In the United States, Denmark, Sweden and Slovakia, the survival rate progressed to 80 percent or better. In Mexico and Brazil, however, less than 40 percent of children diagnosed with brain tumors survived in the 2010-2014 period.

Similarly, five-year survival for the most common type of childhood cancer — acute lymphoblastic leukemia — rose to higher than 90 percent in Canada, the United States and nine European countries, but remained below 60 percent in China and Mexico.

“This likely reflects the availability and quality of diagnostic and treatment services,” the authors said in a statement.

The world has seen across-the-board progress on breast cancer, the study showed.

For women diagnosed with the disease in the United States and Australia between 2010 and 2014, five-year survival was 90 percent. In 16 western European countries, the rate improved to 85 percent, and stood at 71 percent for eastern European nations.

In India, breast cancer survival improved during those five years to 66 percent.

Liver and lung cancers remain quick killers in both rich and developing countries, but the last 20 years have seen some progress.

Between 1995 and 2014, liver cancer survival increased in South Korea (from 11 to 27 percent), Sweden (5 to 17 percent), and Portugal (8 to 19 percent).

Similarly, lung cancer survival went up by 5 to 10 percent in 21 countries, including Britain. The most progress, in addition to Japan, was seen in China (from 8 to 20 percent) and South Korea (10 to 25 percent).

Pancreatic cancer remained highly lethal everywhere, with five-year survival rates typically under 15 percent.

“Greater international efforts are needed to understand the risk factors for this rapidly lethal cancer,” said co-author Michel Coleman, a researcher at the London School of Hygiene & Tropical Medicine.

Led by Claudia Allemani from the London School of Hygiene & Tropical Medicine, the Concord-3 study marshaled hundreds of experts and more than 300 cancer registries covering 37.5 million cancer cases — three-quarters of all the cancers diagnosed worldwide from 2000 to 2014.

Thirty-one European countries were included, along with 17 from Asia and 13 from Latin America. Only six African countries were included, due to a lack of data.

“Despite more than 20 years of advocacy for … fully functional cancer registries, both political and financial support remains woeful,” said Richard Sullivan, a professor at Kings Health Partners Comprehensive Cancer Centre in London.