摘要
我国肝癌发病人数占全球发病总人数的一半以上,在沿海地区发病率较高。在过去40余年中,上海市肝癌发病率和死亡率均下降了近二分之一,下降的主要原因是通过长期的调查研究,确定了乙型肝炎病毒(HBV)感染、黄曲霉毒素和饮水污染是长三角地区罹患肝癌最重要的危险因素,并针对病因在肝癌高发区全面开展"管水、管粮、防肝炎"的预防措施,取得了良好的效果。但是,目前我国仍有近9 400万HBV慢性感染者,其中32%男性和9%的女性将在75岁之前死于肝癌,如何确定何种HBV慢性感染者将发生肝癌并采取抗病毒治疗以预防和推迟癌症发生是目前肝癌防治工作面临的主要挑战。
Liver cancer in China's Mainland alone accounts for more than half of global cases.The occurrence of LC is higher in the coastal areas than in other regions.In the past 40 years or more,the incidence and mortality of LC in Shanghai declined by nearly 50%.The main reason was that chronic infection of hepatitis B virus(HBV),contamination of drinking water,and exposure to aflatoxin in corn and peanut were identified as the most important risk factors(or causes) of LC in Shanghai and the surrounding Delta Region through long-term research.These findings led to active public health activity such as improvements in water treatment,rice protection,and HBV prevention in areas with high incidence of LC.These preventive measures achieved a lot in reducing the disease burden of LC.However,there are approximately 94 million chronic HBV infections.Of those,32% males and 9% females are expected to die of LC before 75 years old.The current challenge in fighting against LC in China is to identify what kind of chronic HBV carriers who will develop LC and to carry out antiviral treatments for reducing or postponing the occurrence of LC.
作者
张宏伟
曹广文
ZHANG Hong-wei;CAO Guang-wen(Department of Epidemiology,Second Military Medical University,Shanghai 200433,China)
出处
《上海预防医学》
CAS
2019年第1期33-40,共8页
Shanghai Journal of Preventive Medicine
基金
国家重点基础研究发展计划(973计划)(2015CB554000)
科技部传染病重大专项(2017ZX10201201-006-001)
国家自然科学基金重大研究计划集成项目(91529305)
国际合作与交流项目(81520108021)
关键词
肝癌
预防
危险因素
成就
挑战
primary liver cancer
prevention
risk factor
achievement
challenge
