近期美国癌症协会在《临床医师癌症杂志》发布美国乳腺癌最新数据报告,1989至2020年间美国乳腺癌患者死亡率下降了43%,相当于同期死亡人数减少了46万。
乳腺癌是美国女性中发病最高的癌症,死亡数仅次于肺癌排名第二。预计2022年美国约有28.7万名女性诊断浸润性乳腺癌,4.3万人死亡;男性约占发病和死亡数的1%。
乳腺癌5年相对生存率为:1期疾病大于99%,2期93%,3期75%,4期29%,有92%的患者在原位或区域癌阶段确诊。早期诊断治疗推动乳腺癌死亡率下降,使其发病位居首位的同时,总生存率达90%位于前五。
上世纪80年代起乳腺X线筛查提高了无症状肿瘤检出率,导致发病率快速上升。截至2000年浸润性乳腺癌发病率增长了40%,导管原位癌甚至增长了10倍以上。2004至2019年间,乳腺CT及PET-CT的普及让诊断率继续呈现缓慢增加的趋势。
此外,雌激素和孕激素的使用,体重指数增加与生育率持续下降,也与乳腺癌发病率增加有关。
专家指出,30%的乳腺癌发病可归因于可预防的风险因素,包括超重、缺乏运动、饮酒等,通过乳房X线等筛查手段可进一步做二级预防。癌症筛查、对民众疾病预防认知的普及、治疗手段的进步,是推动死亡率大幅降低的主要原因。
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