The global burden of cancer is shifting dramatically. Once considered a disease of the wealthy, it now has a significant impact in every region, and the greatest proportional increases in cases in the coming years are predicted to be in the poorest corners of the world. Worldwide, an estimated 14.1 million new cancer cases were diagnosed in 2012 and 8.2 million cancer deaths.
全球的癌癥負(fù)擔(dān)有了巨大轉(zhuǎn)變。以前人們把癌癥視為“富人病”，現(xiàn)在這種病卻給全球帶來(lái)了巨大影響。未來(lái)幾年中，患癌比例的最高增幅預(yù)計(jì)會(huì)出現(xiàn)在世界上最窮的地區(qū)。2012年全球新增癌癥病例約1410萬(wàn)例，死亡患者達(dá)820萬(wàn)人。

In an analysis that maps the world's hot spots for cancer, epidemiologist Lindsey Torre found a tremendous heterogeneity in which forms of the disease are most commonly diagnosed in different countries.
在全球癌癥熱點(diǎn)分布圖中，流行病學(xué)家林德賽·托爾發(fā)現(xiàn)了一種極不均勻的分布特點(diǎn)——各國(guó)常患癌癥的類型各不相同。

Among the most significant trends they identified is a growing inequality between high-income countries and lower-income countries in cancer diagnoses — with cancer rates declining in high-income countries but rising in lower-income countries.
他們發(fā)現(xiàn)，最突出的一個(gè)趨勢(shì)便是高收入國(guó)家和低收入國(guó)家在患癌率上越來(lái)越不均衡——高收入國(guó)家的癌癥患病率下降，而低收入國(guó)家的癌癥患病率上升。

The difference is especially striking in lung, colorectal and breast cancer. Better screening, early detection and access to treatment plus a decrease in risk factors like smoking probably explain part of the positive trend among the high-income countries.
其中，以肺癌、結(jié)腸癌和乳腺癌的差距尤甚。或許更好的篩查條件、早發(fā)現(xiàn)早治療以及類似吸煙等誘因的減少能解釋高收入國(guó)家癌癥患病率下降的原因。

As for the rising cancer rates in lower-income countries, "it's related to the adoption of a Western lifestyle," Torre explained in an interview. "People are less active," she said. "There is less manual labor and more use of transport. They have access to perhaps more appealing but less healthy foods."
托爾在一次采訪中說(shuō)道，至于低收入國(guó)家的癌癥患病率為什么越來(lái)越高，“或許是與采用西方的生活方式有關(guān)。”他說(shuō)道，“人們的運(yùn)動(dòng)越來(lái)越少。體力勞動(dòng)減少，交通工具的使用增多，人們還可以吃到更美味但并不是那么健康的食物。”

Developing countries also bear a disproportionate burden of infection-related cancers related to the stomach bug helicobacter pylori, hepatitis and human papillomavirus (HPV)?.
在幽門螺桿菌、肝炎和人乳頭瘤病毒（HPV）等能致使腸胃細(xì)菌感染的感染性相關(guān)癌癥上，發(fā)展中國(guó)家的負(fù)擔(dān)也并不均衡。

Addressing this inequality is critical, the researchers wrote in the journal Cancer Epidemiology, Biomarkers & Prevention, because "a large proportion of cancers can be prevented through measures including tobacco control, vaccination, early detection, and promotion of healthy lifestyles."
研究人員在期刊《癌癥流行病學(xué)、生物標(biāo)記及預(yù)防》上寫道，解決不均衡現(xiàn)象至關(guān)重要，因?yàn)椤安扇☆A(yù)防措施能大幅減少癌癥患病率，比如控?zé)煛⒔臃N疫苗、及早發(fā)現(xiàn)和推廣健康的生活方式。”

"In addition, the burden of suffering can be reduced through appropriate treatment and palliative care. To apply these cancer control measures equitably around the world, a concerted effort will be required not only from individual country governments but also from international agencies, donors, civil society," they said.
他們還說(shuō)道，“此外，患病的痛苦也可以通過適當(dāng)?shù)闹委熀凸孟⒆o(hù)理得到減緩。要想在全球范圍內(nèi)均衡地推廣這些管控手段，不僅需要各國(guó)政府的齊心協(xié)力，國(guó)際機(jī)構(gòu)、捐贈(zèng)者和公民社會(huì)也要傾力合作。”

Torre and her colleagues at the American Cancer Society analyzed incidence and mortality data for 2003-2007 from the International Agency for Research on Cancer databases and mortality data from the World Health Organization through 2012. They selected 50 countries selected to represent various regions of the world and focused on eight major cancers.
托爾和來(lái)自美國(guó)癌癥學(xué)會(huì)的幾位同事分析了國(guó)際癌癥研究機(jī)構(gòu)的數(shù)據(jù)庫(kù)中，2003年-2007年癌癥患者的發(fā)病率和死亡率，還研究了世界衛(wèi)生組織2012年的死亡率數(shù)據(jù)。他們選出50個(gè)分布在世界各地的國(guó)家，并著手調(diào)查這些國(guó)家中八種主要癌癥的發(fā)病情況。

Among males, prostate cancer is the most commonly diagnosed cancer in most countries, with the exception of those in Eastern Europe where lung cancer is the No. 1 cancer. Among females, breast cancer is the most common among those in North America, Europe and Oceania. There's more diversity in Asia, where lung cancer ranks first in China and North Korea, liver in Laos and Mongolia and thyroid in South Korea.
男性中，大多數(shù)國(guó)家最常確診的癌癥是前列腺癌，但東歐地區(qū)發(fā)病率最高的卻是肺癌。女性中，北美、歐洲和大洋洲發(fā)病率最高的是乳腺癌。亞洲癌癥發(fā)病的類型較多，中國(guó)和朝鮮排名第一的癌癥是肺癌，老撾和蒙古則是肝癌，韓國(guó)是甲狀腺癌。

Vocabulary

heterogeneity: 不均勻性
colorectal: 結(jié)腸直腸的
palliative care: 姑息治療，臨終關(guān)懷
thyroid: 甲狀腺

英文來(lái)源：華盛頓郵報(bào)
譯者：許楠楠
審校&編輯：丹妮