The Lancet Oncology\u2019de yay\u0131mlanan ara\u015ft\u0131rma, 2023 y\u0131l\u0131nda 2,3 milyon kad\u0131na meme kanseri te\u015fhisi kondu\u011funu g\u00f6steriyor. D\u00fc\u015f\u00fck gelirli \u00fclkelerde \u00f6l\u00fcm oranlar\u0131 neredeyse iki kat\u0131na \u00e7\u0131karken, y\u00fcksek gelirli \u00fclkelerde bu oranlar azald\u0131.<\/p>\n\n\n\n
The Lancet Oncology dergisinde Pazartesi g\u00fcn\u00fc yay\u0131mlanan verilere g\u00f6re, d\u00fcnya genelinde kad\u0131nlarda en s\u0131k rastlanan kanser t\u00fcr\u00fc olan meme kanseri vakalar\u0131n\u0131n 2050 y\u0131l\u0131na kadar 3,5 milyonu ge\u00e7mesi \u00f6ng\u00f6r\u00fcl\u00fcyor.
Otuz y\u0131l\u0131 a\u015fk\u0131n s\u00fcrenin verileri ve 204 \u00fclke ile b\u00f6lgeyi kapsayan \u00e7al\u0131\u015fma, k\u00fcresel \u00e7apta e\u015fitsizli\u011fin giderek b\u00fcy\u00fcd\u00fc\u011f\u00fcn\u00fc ortaya koyuyor. Y\u00fcksek gelirli \u00fclkelerde 1990\u20132023 y\u0131llar\u0131 aras\u0131nda ya\u015fa g\u00f6re standardize edilmi\u015f oranlarla meme kanserine ba\u011fl\u0131 \u00f6l\u00fcmler yakla\u015f\u0131k y\u00fczde 30 azalm\u0131\u015fken, d\u00fc\u015f\u00fck gelirli \u00fclkelerde ayn\u0131 d\u00f6nemde \u00f6l\u00fcm oranlar\u0131 neredeyse y\u00fczde 99 art\u0131\u015f g\u00f6sterdi.
2023\u2019te d\u00fcnya genelinde yakla\u015f\u0131k 2,3 milyon kad\u0131na meme kanseri te\u015fhisi konuldu, 764 bin kad\u0131n hayat\u0131n\u0131 kaybetti. O y\u0131l kad\u0131nlarda te\u015fhis edilen her d\u00f6rt kanserden biri meme kanseriydi.<\/p>\n\n\n\n
Tablo Sahra Alt\u0131 Afrika\u2019da A\u011f\u0131rla\u015f\u0131yor
Sahra Alt\u0131 Afrika\u2019da, \u00f6zellikle \u00f6l\u00fcm oranlar\u0131 k\u00fcresel ortalaman\u0131n iki kat\u0131n\u0131 ge\u00e7iyor. Orta ve Bat\u0131 Afrika\u2019da her 100 bin ki\u015fide, ya\u015fa g\u00f6re ayarlanan oranlarla yakla\u015f\u0131k 35 ki\u015fi hayat\u0131n\u0131 kaybediyor.
Ara\u015ft\u0131rman\u0131n k\u0131demli yazar\u0131 Dr. Lisa Force, d\u00fc\u015f\u00fck gelirli \u00fclkelerde e\u015fitsizli\u011fin artt\u0131\u011f\u0131n\u0131, y\u00fcksek gelirli \u00fclkelerde ise ilerleme kaydedildi\u011fini belirtti. Massachusetts General Hospital\u2019dan onkolog Dr. Kamal Menghrajani, \u00e7al\u0131\u015fmaya dahil olmasa da, \u201cKanserden sa\u011f kal\u0131m, ya\u015fad\u0131\u011f\u0131n\u0131z \u00fclkeye ba\u011fl\u0131 olmamal\u0131\u201d yorumunu yapt\u0131.<\/p>\n\n\n\n
Belirleyici Olan Altyap\u0131 A\u00e7\u0131\u011f\u0131
Artan te\u015fhis say\u0131lar\u0131 ile mevcut tedavi altyap\u0131s\u0131 aras\u0131ndaki uyumsuzluk, uzmanlara g\u00f6re as\u0131l sorun olarak \u00f6ne \u00e7\u0131k\u0131yor. Meme kanseri tedavisinde cerrahi, radyoterapi ve kemoterapi ile hedefe y\u00f6nelik tedavilerin uyum i\u00e7inde uygulanmas\u0131 gerekiyor. Bu hizmetler ABD gibi \u00fclkelerde yayg\u0131n ve sigorta kapsam\u0131na dahil.
Sahra Alt\u0131 Afrika\u2019da ise tablo olduk\u00e7a farkl\u0131. \u00c7al\u0131\u015fma verilerine g\u00f6re, 2020 itibar\u0131yla Afrika \u00fclkelerinin sadece yar\u0131s\u0131nda en yayg\u0131n radyoterapi t\u00fcr\u00fc olan d\u0131\u015ftan \u0131\u015f\u0131nl\u0131 tedavi sunulabiliyor. Mevcut kapasite hi\u00e7bir \u00fclkede ihtiya\u00e7lar\u0131 tamamen kar\u015f\u0131lam\u0131yor.
Radyoterapinin bulunmad\u0131\u011f\u0131 yerlerde mastektomi \u00e7o\u011fu zaman varsay\u0131lan tedaviye d\u00f6n\u00fc\u015f\u00fcyor. Ancak ameliyat sonras\u0131 bak\u0131m ve sistemik tedaviler olmadan cerrahinin etkinli\u011fi s\u0131n\u0131rl\u0131 kal\u0131yor.
Maliyet de \u00f6nemli bir engel. Yayg\u0131n bir alt tip i\u00e7in kullan\u0131lan hedefe y\u00f6nelik trastuzumab tedavisi, baz\u0131 d\u00fc\u015f\u00fck gelirli \u00fclkelerde ortalama gelirin yakla\u015f\u0131k on kat\u0131na mal olabiliyor.<\/p>\n\n\n\n
DS\u00d6\u2019n\u00fcn Hedefi Tehlike Alt\u0131nda
World Health Organization\u2019\u00fcn K\u00fcresel Meme Kanseri Giri\u015fimi, \u00f6l\u00fcm oranlar\u0131n\u0131n her y\u0131l y\u00fczde 2,5 azalmas\u0131n\u0131 hedefliyor. Mevcut gidi\u015fata bak\u0131ld\u0131\u011f\u0131nda ise, ara\u015ft\u0131rmalar bu hedefin bir\u00e7ok \u00fclkede gerisinde kalabilece\u011fini g\u00f6steriyor.
Giri\u015fim \u00fc\u00e7 temel s\u00fctuna dayan\u0131yor:
\u00a0 \u00a0\u2022 Kanserin erken evrede saptanmas\u0131
\u00a0 \u00a0\u2022 Belirti sonras\u0131 h\u0131zl\u0131 tan\u0131
\u00a0 \u00a0\u2022 Kapsaml\u0131 ve eri\u015filebilir tedaviye ula\u015f\u0131m
\u00a0 \u00a0\u2022 Ara\u015ft\u0131rmac\u0131lar, siyasi irade ve sa\u011fl\u0131k sistemine yat\u0131r\u0131m olmadan k\u00fcresel e\u015fitsizli\u011fin kapanmas\u0131n\u0131n zor oldu\u011funu vurguluyor.<\/p>\n\n\n\n
ABD\u2019de E\u015fitsizlik H\u00e2l\u00e2 S\u00fcr\u00fcyor
Y\u00fcksek gelirli \u00fclkelerde dahi e\u015fitsizliklerin s\u00fcrd\u00fc\u011f\u00fc, \u00e7al\u0131\u015fma taraf\u0131ndan ortaya kondu. Meme kanserine ba\u011fl\u0131 \u00f6l\u00fcm oran\u0131 ABD\u2019de siyah kad\u0131nlarda, beyaz kad\u0131nlara k\u0131yasla yakla\u015f\u0131k y\u00fczde 40 daha fazla. Uzmanlara g\u00f6re bu fark, bak\u0131m s\u00fcre\u00e7lerindeki \u00f6nyarg\u0131lar, tedaviye eri\u015fim sorunlar\u0131 ve ge\u00e7 te\u015fhis ile ba\u011flant\u0131l\u0131.<\/p>\n\n\n\n
Risk Nas\u0131l Azalt\u0131labilir?
Uzmanlar, ya\u015fam tarz\u0131 de\u011fi\u015fikliklerinin riski tamamen ortadan kald\u0131rmad\u0131\u011f\u0131n\u0131 ancak azaltabilece\u011fini belirtiyor.
\u00d6neriler aras\u0131nda: <\/p>\n\n\n\n
\u00a0\u2022 K\u0131rm\u0131z\u0131 et t\u00fcketimini s\u0131n\u0131rlamak\u2028<\/p>\n\n\n\n
\u00a0\u2022 T\u00fct\u00fcn kullan\u0131m\u0131n\u0131 b\u0131rakmak\u2028<\/p>\n\n\n\n
\u2022 Kan \u015fekerini kontrol alt\u0131nda tutmak\u2028\u00a0<\/p>\n\n\n\n
\u2022 Sa\u011fl\u0131kl\u0131 kiloyu korumak\u2028\u00a0<\/p>\n\n\n\n
\u2022 Alkol t\u00fcketimini azaltmak\u2028\u00a0 <\/p>\n\n\n\n
\u00a0\u2022 D\u00fczenli fiziksel aktivite
\u2028US Preventive Services Task Force, ABD\u2019de 40\u201374 ya\u015f aral\u0131\u011f\u0131ndaki kad\u0131nlara mamografiyi iki y\u0131lda bir \u00f6neriyor. \u00d6zellikle obezite veya aile \u00f6yk\u00fcs\u00fc gibi risk fakt\u00f6rleri bulunan ki\u015filerin, birinci basamak sa\u011fl\u0131k hizmeti sa\u011flay\u0131c\u0131s\u0131yla g\u00f6r\u00fc\u015fmesini uzmanlar tavsiye ediyor.
Standart rehberlerde ayl\u0131k kendi kendine meme muayenesi ise art\u0131k yer alm\u0131yor. Kad\u0131nlar\u0131n bunun yerine v\u00fccutlar\u0131n\u0131 tan\u0131mas\u0131; meme ba\u015f\u0131nda farkl\u0131l\u0131k, cilt de\u011fi\u015fikli\u011fi, memede yeni bir kitle ya da \u015fekil de\u011fi\u015fimi fark etti\u011finde sa\u011fl\u0131k kurulu\u015funa gecikmeden ba\u015fvurmas\u0131 \u00f6neriliyor.
Mamografi ile ABD\u2019deki meme kanseri vakalar\u0131n\u0131n b\u00fcy\u00fck b\u00f6l\u00fcm\u00fc uzmanlara g\u00f6re saptan\u0131yor. Bireysel d\u00fczeyde en etkili koruyucu ad\u0131m olarak tarama programlar\u0131na d\u00fczenli kat\u0131l\u0131m \u00f6ne \u00e7\u0131k\u0131yor.<\/p>\n\n\n\n