中国胃癌的筛查与防控进展
Progress in Screening, Prevention and Control of Gastric Cancer in China

胃癌是全球范围内常见的恶性肿瘤之一，在不同地区的发病率和死亡率存在显著差异。据世界卫生组织(WHO)数据显示，胃癌是全球第五大常见的癌症，也是第三大癌症死亡原因，胃癌已成为威胁我国国民生命健康的重大疾病，其所造成的疾病负担逐年攀升。然而我国胃癌患者早诊率低、病死率高、预后较差，5年生存率仍不到40%，胃癌防控面临重大挑战。根除幽门螺杆菌可显著降低胃癌及其癌前病变发生的风险，是明确的人类胃癌的一级预防措施。幽门螺杆菌是一种与多种重大慢性疾病相关的致病菌，是目前唯一确定的与胃癌发生密切相关的细菌性病原体，被列为I类致癌因子。在我国，居民幽门螺杆菌总体感染率近50%，农村感染率高于城市，成人感染率高于儿童，具有人群感染率高、疾病负担重、耐药率高的特征。然而，我国幽门螺杆菌感染基数庞大，患者的疾病负担被严重低估，公众对幽门螺杆菌感染的危害及根除获益知晓程度较低，幽门螺杆菌感染区域防治水平差异较大，我国需要在医疗公共卫生防控体系中持续加快提升幽门螺杆菌感染防控能力，形成科学有效的传染病防控合力，进一步满足公众当前对医疗卫生服务的需求。本研究从我国胃癌疾病负担，防控手段角度，结合我国胃癌防控瓶颈问题展开综述。
Gastric cancer is one of the common malignant tumors worldwide, with significant differences in incidence and mortality in different regions. According to the data of the World Health Organization (WHO), gastric cancer is the fifth most common cancer in the world and the third leading cause of cancer death. Gastric cancer has become a major disease that threatens the life and health of Chinese people, and its disease burden is increasing year by year. However, the early diagnosis rate of gastric cancer patients in China is low, the mortality rate is high, and the prognosis is poor. The 5-year survival rate is still less than 40%, and the prevention and control of gastric cancer is facing major challenges. Eradication of Helicobacter pylori can significantly reduce the risk of gastric cancer and its precancerous lesions, which is a clear primary prevention measure for human gastric cancer. Helicobacter pylori is a pathogenic bacterium associated with a variety of major chronic diseases. It is the only bacterial pathogen closely related to gastric cancer, and is classified as a class I carcinogen. In China, the overall infection rate of Helicobacter pylori is nearly 50%, with the infection rate in rural areas higher than that in cities, and the infection rate in adults higher than that in children. It has the characteristics of high population infection rate, heavy disease burden, and high drug resistance rate. However, the infection base of H. pylori is huge in China, the disease burden of patients is seriously underestimated, the public awareness of the harm and eradication benefits of H. pylori infection is low, and the regional prevention and control level of H. pylori infection is large. China needs to continue to accelerate the prevention and control ability of H. pylori infection in the medical public health prevention and control system, form a scientific and effective infectious disease prevention and control synergy, and further meet the current