Kelto: Breast cancer, colon cancer, stomach cancer―more people are surviving these diseases than ever before, especially in the U.S. and Europe. Some low-income and middle-income countries are making progress, too. Coleman: There are many countries in Latin America, for example, and Southeast Asia where survival has improved quite 6)markedly. Even in Mongolia there have been quite sizable increases in survival from some cancers.
Kelto: But then, there’s the bad news. The study published in The Lancet shows that there’s still a huge gap between rich countries and poor ones. Take childhood 7)leukemia. In the U.S., 9 out of 10 kids who get it will live. Now compare that―a 90 percent survival rate―to some poorer nations.
Coleman: In Jordan, it’s 16 percent. In 8)Lesotho in southern Africa, it’s 40 percent. And in the central region of 9)Tunisia in northern Africa, it is 50 percent.
Kelto: There are also countries where we have no idea how many kids are dying from leukemia because there just isn’t good data. So just how bad is it in these places? I asked that to Dr. Corey Casper, the head of global 10)oncology at the Fred Hutchinson Cancer Research Center in Seattle. He told me about this doctor he met in Uganda a few years ago.
Kelto: That guy was literally the only cancer doctor for Uganda and four surrounding countries. And then there are cultural barriers, too.
Casper: Uganda has 57 different tribes, and there are different languages within each of those tribes. And many of them don’t even have a word for cancer because it’s so not part of, you know, the local culture. Kelto: So people go a very long time before they even realize they have a problem. And when they seek care, it’s usually too late.
Coleman: More than 75 percent of the patients who come to the Cancer Institute in Uganda come with stage three or four cancer.
Kelto: But Casper says look, it’s not all 13)doom and 14)gloom. Uganda is opening up a 10-million-dollar cancer center next month. And smaller centers have sprung up elsewhere in Africa and in Latin America and Southeast Asia. And he says it’s no big surprise that the countries making the biggest 15)strides are the ones investing the most in cancer care.
奥迪・科尼什(主持人):有史以来最大的全球癌症研究报告发表了――这项研究调查了超过2700万癌症病人。由此得到了如下数据:在发展中国家,死于癌症的人数比死于艾滋病、疟疾和肺结核人数的总和还多。据NPR新闻的安德斯・科洛图报道,这项研究报告同时也揭示出了全球癌症存活率的一个巨大差异。
安德斯・科洛图(撰稿人):因此大体上,由此得到的消息有好有坏。有请这项研究的作者之一―来自伦敦卫生和热带医药学院的迈克尔・科尔曼医生。
迈克尔・科尔曼:好消息是,在大多数国家,一些最常见癌症的存活情况一直有所改善。
科洛图:乳腺癌、结肠癌、胃癌――比起以往任何时候,更多的人能够在这些疾病中存活下来,特别是在美国和欧洲。一些低收入和中等收入的国家也在改善中。
科尔曼:例如,许多拉丁美洲的国家以及东南亚地区癌症存活的情况得到了显著的改善。甚至在蒙古,一些癌症存活率也得到了大幅度的提高。
科洛图:但是,也有不好的消息。发表在《柳叶刀》(译者注:该杂志是目前世界医学界最权威的学术刊物之一)的研究表明,(癌症存活率)在富国和穷国之间依然存在着巨大的差异。以儿童白血病为例。在美国,10个病孩里有9个都能活下去。现在把这90%的存活率与一些相对贫困的国家相比。
科尔曼:在约旦,是16%;在南非的莱索托,是40%;在北非突尼斯的中部地区,是50%。
科洛图:还有一些国家我们无从得知有多少孩子死于白血病,因为那里的数据还不够完善。那么在这些地方情况有多糟呢?我咨询了科里・卡斯珀医生,他是西雅图费雷德・哈钦森癌症研究中心全球肿瘤学的负责人。他跟我说起了他几年前在乌干达遇到的一位医生。
科里・卡斯珀:这位医生一个人每年要给1万名病人看病。那里的设施,你知道的―没有屋顶、间断的电源以及药物供应不足。
科洛图:这个人事实上是乌干达和其周边四个国家唯一的癌症医生。然而那里也存在着文化障碍。
卡斯珀:乌干达有57个不同的部落,每个部落都有不同的语言。很多部落甚至没有癌症专用的一个词,因为你懂的,这不是当地文化的一部分。
科洛图:所以那里的人们用了很长的时间才意识到自己的问题。而当他们寻求医治的时候,通常为时已晚。
科尔曼:超过75%的患者在来到乌干达癌症研究所的时候,癌症已经到了3期或者4期了。
科洛图:但是卡斯珀说,其实情况也没有那么凄惨。乌干达在下个月将要成立一个耗资1000万美元的癌症中心。小的中心也陆续在非洲其他地区、拉丁美洲和东南亚出现。他说毫无疑问那些在癌症治疗投入最多的国家一定会在这方面取得最大的进展。