China moves to promote a package of prevention and treatment standards for breast cancer across the country, in the hope of further prolong the duration of life of patients and reduce the diagnosis and treatment of rupture between urban and rural areas.
Guidance Series covering screening of breast cancer, early diagnosis and treatment and management of medical products in subsequent treatment and management of co-morbidities were released on Saturday constant cancer and medical conference jointly conducted by the National Cancer Center (NCC), Cancer Foundation China, Beijing breast society diseases and other related agencies.
Data published by the NCC in March 2018 showed that the death rate from breast cancer in China accounted for 16.5 percent of all cancers in women. As breast cancer continues to claim the top-level of morbidity, both at home and abroad, its cure rate is improved steadily in China, with a survival rate of five years, reaching 83.2 percent in the period from 2010 to 2014, an increase of 7, 3 percent from 2000.
Since life expectancy has increased significantly more patients entered the chronic phase of the disease, in accordance with the guidelines for surveillance of breast cancer and overall management of opportunistic diseases, particularly such a situation in China, the NCC.
Common comorbidities breast cancer include cardiovascular disease, abnormal bone metabolism, and depression. "Among the elderly patients, heart disease caused more deaths than cancer itself," said Ma Fei, the executive chairman of the conference and an expert from the NCC.
Under the double effect of ovarian dysfunction and drugs, postmenopausal patients suffer sharp decline in estrogen levels, which often leads to an abnormal amount of lipids in the blood and increases the risk of cardiovascular disease, explains Ma.
In addition, a large number of patients will continue to receive endocrine therapy for five to 10 years after treatment for cancer, which is often accompanied by abnormal bone metabolism, osteoporosis and even fractures.
The guidance clearly requires physicians through interdisciplinary collaboration, taking into account the level of lipids in the blood and the bone density of a patient before giving endocrine therapy. He also believes that doctors intervene to help patients quit smoking and drinking alcohol, as well as to avoid falls and Sur & # 39; serious consequences for the body in accordance with an assessment of their overall health.
Xu Binghe, professor of NCC, which focus on the treatment of breast cancer for more than three decades, cancer, noted that the principles by standardizing the follow-up visits and examinations, would bring the prevention of possible accompanying diseases earlier than before, and expand the provision of medical assistance to the victims for throughout their lives.
"It will definitely help the patients to return to his family & # 39; and society and in the best condition," Xu said.
We Fairies consider the guidelines as an important step to change in disease diagnosis and treatment center model in a patient-centered. "Patients should not only live longer, but to live well," he said.
China has published a plan for the development of public health "Healthy China 2030" in 2016 to raise the entire cancer survival rate five years by 15 percentage points by 2030.
With regard to breast cancer, the survival rate five years strongly Var & # 39; irue among different regions. In the eastern coastal cities have reported survival rate of 90 percent, about the same level as in the developed Western countries, while the inner and rural area rate is lower by 70 to 80 percent.
In addition, the incidence of breast cancer in China is still growing by 3 to 4 percent per year, which is higher than the world average.
"In order to further improve breast cancer in China, the cure rate, early diagnosis and treatment are very important. Until now, no more than 20 percent of breast cancer cases are detected at an early stage, and less than 5 percent found screening, "Ma said.
China began to promote free breast cancer and cervical cancer screening in rural areas of cancer among women since 2009. But how to choose among the various screening methods, particularly targeted at different age groups, there is still no uniform standards. Lack of screening professionals also led to a high level of false or missed diagnosis.
NCC has also issued recommendations for screening and early diagnosis and treatment at the conference, which determines the purpose and methods of screening and early diagnosis and treatment path.
While the US and European countries recommend a mammogram as a primary screening method, these recommendations suggest that the best option for Chinese patients to combine mammography with ultrasound.
"We can not just copy the international rules. For example, Western women tend to have larger breasts with more fat, very suitable for mammography, but the Chinese women often have smaller breasts with higher density, better for ultrasound equipment, "explained Ma.
"Coverage of healthy people, and paying particular attention to high-risk groups, the recommendations will help to increase the early detection of breast cancer," he said.
The consensus on the diagnosis and treatment of young patients who want to maintain normal fertility was also released during the conference.
According to Ma, the peak age incidence of breast cancer in China is from 10 to 15 years earlier than in western countries, many patients younger than 35 years. Most of these patients do not give birth and still desire to have children.
It is almost impossible for young patients to avoid chemotherapy, which usually contains cyclophosphamide (CTX), that & # 39 is harmful to the reproductive system. Endocrine therapy can also lead to infertility due to its effects on the uterus and ovaries, said Ma.
The study shows that, although more than half of patients in China are concerned about the issue of procreation, very few are asked to adjust their treatment plans.
Consensus suggests that young patients should all get genetic counseling, regardless of their family history, and doctors think about the adverse effects of CTX for younger patients who want pregnancy.
"The consensus fills a gap in helping protect the reproductive health of patients with cancer and provides practical operational instructions for medical institutions at all levels, marking a new step towards the creation of a common control system for breast cancer in China," said Ma.
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