作者：Zosia Chustecka
出處：WebMD醫學新聞
September 1, 2008 — 日前在瑞士日內瓦世界癌症研討會的閉幕式中，宣布一個全球處理開發中國家越來越多癌症危機的雛型，該計畫有11個行動步驟，是根據兩年前的世界癌症宣言。
雖然許多富裕國家的癌症存活率有所改善，但開發中國家的意外與死亡率卻惡化，此差距預期會越來越大；2007年全世界約有790萬例癌症死亡，但是其中72%發生在中低收入國家，這些國家控制癌症的資源有限，甚至付諸闕如。
世界衛生組織主任Margaret Chan醫師表示，較不富裕國家的癌症增加是一個逼近的災難，現在應該將開發中國家的癌症控制列為優先事項。
根據世界癌症宣言，為了處理即將來臨危機的此一計畫，匯集了63名癌症專家和政策制定者，該小組指出需要降低抽菸率、肥胖、飲酒，也提出實施普遍的疫苗接種計畫防止癌症，特別是預防肝癌的B型肝炎疫苗，以及預防子宮頸癌的人類乳突病毒疫苗。
其他步驟包括改善癌症病患的疼痛控制，特別是鴉片類止痛劑，這在開發中國家難以被使用；專家指出，全世界約有90%的嗎啡使用在歐洲和北美。
另外一個步驟是，大眾教育活動，以消除有關癌症的迷思和錯誤觀念；該小組表示，約有三分之一的癌症案例是可以預防的，其他三分之一如果早期發現且適當治療是可以治癒的；菸草是引起許多癌症的單一最大可預防因素，但是在中低收入國家的抽菸人口增加，這仍舊是全球的一大問題。
該計畫是在一場高峰會中彙整，共同主席是前任聯合國人權事務高級專員Mary Robinson、國際抗癌聯合會(UICC)即將卸任的主席Franco Cavalli醫師；Cavalli醫師是南瑞士腫瘤研究中心主任、瑞士Bern大學與義大利Varese大學的腫瘤科教授。
Robinson女士表示，癌症控制是一個人權問題，更重要的是，是一個人類尊嚴問題；她指出，實現世界癌症宣言是實際承諾的另一個步驟—一個願景— 得以處理這個重大的世界健康議題。
該小組建議將目標設定在2020年，並列出許多優先行動；將配合兩年一次的世界癌症研討會，每兩年提出這些目標的發展報告；下一屆會議將在2010年8月18至21日於中國北京舉行。
有關世界癌症宣言的詳情，可以在UICC 網站獲得，包括登入以支持此計畫的細節。
Global Plan to Tackle Growing Cancer Crisis in Developing Countries
By Zosia Chustecka
Medscape Medical News
September 1, 2008 — A global template for tackling the growing cancer crisis in developing countries was announced yesterday at the close of the World Cancer Congress in Geneva, Switzerland. The plan proposes 11 action steps, and builds on the World Cancer Declaration adopted 2 years ago.
Although survival rates from cancer are improving in the more affluent countries, both incident and death rates are worsening in the developing world, and this gap is expected to widen. Worldwide, cancer accounted for 7.9?million deaths in 2007, but 72% of these deaths occurred in low- and middle-income countries, where resources available for cancer control are limited or nonexistent.
"The rise of cancer in less affluent countries is an impending disaster," said Margaret Chan, MD, director-general of the World Health Organization. "The time is right to make cancer control a developmental priority."
The plan for tackling the impending crisis, contained in the World Cancer Declaration, was put together by a group of 63 cancer experts and policy makers. The group highlighted the need to reduce tobacco consumption, obesity, and alcohol intake, and proposed implementing universal vaccination programs to prevent cancer, specifically for hepatitis?B to prevent liver cancer and for human papillomavirus to prevent cervical cancer.
Other steps include improving the provision of pain relief for cancer patients, particularly opioid analgesics, which are hardly used in developing countries. Around 90% of worldwide morphine use occurs in Europe and North America, the experts pointed out.
Another step proposed was for public education campaigns to dispel myths and misconceptions about cancer. About one third of cancer cases can be prevented, and another third can be cured if detected early and treated properly, the panel said. Tobacco is the single largest preventable cause of a range of different cancers, yet smoking continues to increase in low- and middle-income countries and remains a major global problem, experts pointed out.
The plan was put together during a summit cochaired by Mary Robinson, former United Nations High Commissioner for Human Rights, and Franco Cavalli, MD, outgoing president of the International Union Against Cancer (UICC). Dr. Cavalli is a director of the Oncology Institute of Southern Switzerland, in Bellinzona, and professor of medical oncology at the University of Bern, in Switzerland, and the University of Varese, in Italy.
Cancer control is "a question of human rights and, above all, it is a question of human dignity," Ms. Robinson commented. "Adoption of the World Cancer Declaration is another step in a real commitment — a vision — of how to tackle this huge world-health issue," she added.
The group recommended targets for 2020 and defined a list of priority actions. Progress reports on the targets will be produced every 2 years, to coincide with the biannual World Cancer Congress; the next one will be held in Beijing, China, August 18 to 21, 2010.
Details about the World Cancer Declaration, including an option to sign in support for the plan, can be found on the UICC website.
[ 本帖最後由 goodcat1111 於 2008-9-10 23:04 編輯 ] |
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