The Lancet Regional Health: Western Pacific最新文献

{"title":"Protecting against genetic discrimination requires more than a law.","authors":"The Lancet Regional Health-Western Pacific","doi":"10.1016/j.lanwpc.2026.101975","DOIUrl":"10.1016/j.lanwpc.2026.101975","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"73 ","pages":"101975"},"PeriodicalIF":9.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term projections of cancer prevalence in Australia to 2050: a population-based statistical modelling study.","authors":"Qingwei Luo, David P Smith, Michael David, Eleonora Feletto, Clare Kahn, Julia Steinberg, Michael Jefford, Karen Canfell","doi":"10.1016/j.lanwpc.2026.101946","DOIUrl":"10.1016/j.lanwpc.2026.101946","url":null,"abstract":"<p><strong>Background: </strong>Cancer prevalence is the number of people alive with a past cancer diagnosis in a specified number of previous years (e.g., last 5 or 30 years). This study estimates 1- to 30-year cancer prevalence in Australia for each year in 2025-2050, for 24 cancer types, the group of remaining cancers, and for all cancers combined.</p><p><strong>Methods: </strong>We used validated methods to estimate prevalence as a function of incidence and survival, using tabulated data from the Australian Institute of Health and Welfare and incorporating the effect of influential cancer-specific factors. The number of people living with cancer (cancers not yet cured) is estimated using the time-to-cure method.</p><p><strong>Findings: </strong>The 30-year prevalence is projected to increase by 57.1% from 1,666,020 (95% uncertainty interval [UI]: 1,553,825-1,784,900) in 2025 to 2,617,016 (95% UI: 2,333,949-2,947,174) in 2050. For people aged 80+ years, 30-year prevalence is projected to increase by 111.0% from 481,079 (95% UI: 448,799-515,286) in 2025 to 1,015,061 (95% UI: 917,670-1,125,036) in 2050. Breast cancer is projected to be the most prevalent cancer in Australia in 2050, followed by prostate, melanoma and colorectal cancer. For 30-year prevalence in 2050, 43.9% of people (1,149,364; 95% UI: 1,103,165-1,238,377) are estimated to be living with cancer (cancers not yet cured) and requiring initial treatment or ongoing care.</p><p><strong>Interpretation: </strong>A substantial increase in the number of people with a past cancer diagnosis in Australia is expected in 2025-2050. Expansion of appropriate services to meet the demand will be a key challenge for the health system in Australia.</p><p><strong>Funding: </strong>This work was not supported by a dedicated research grant. This work and open access publishing were supported by the Cancer Council NSW, through funding to the Daffodil Centre. KC is a recipient of a Fellowship from the National Health and Medical Research Council of Australia (APP1194679). JS is a recipient of a Cancer Institute NSW Career Development Fellowship (2022/CDF1154).</p>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"73 ","pages":"101946"},"PeriodicalIF":9.4,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infection-driven cancers in Asia: implications from epidemiological transitions.","authors":"Yingsong Lin, Manami Inoue","doi":"10.1016/j.lanwpc.2026.101957","DOIUrl":"10.1016/j.lanwpc.2026.101957","url":null,"abstract":"<p><p>Gastric, liver, and cervical cancers account for a disproportionate share of the global cancer burden, particularly in Asia, where infection-related cancers remain a major public health challenge. This narrative review aims to provide an overview of the epidemiological transition of these cancers and their implications for cancer control in Asia. Updated population-attributable fractions and other epidemiological evidence indicate a declining contribution of infections to overall cancer incidence, reflecting ongoing epidemiological transitions. While prevention of infection-driven cancers in Asia requires pathogen-specific strategies, they should be adapted to the changing epidemiological patterns. Population-wide <i>Helicobacter pylori</i> eradication combined with risk-stratified screening represents an effective strategy to reduce gastric cancer burden. Liver cancer prevention increasingly requires tackling viral and emerging metabolic risk factors. HPV- and HBV-related cancers are largely preventable through vaccination, although coverage remains uneven across Asia. EBV contributes substantially to nasopharyngeal cancer burden in East and Southeast Asia, highlighting persistent geographic disparities. Given substantial heterogeneity in the prevalence of major infectious agents and health-system capacity across countries, effective prevention strategies should be tailored to country-specific contexts, balancing benefits, risks, and cost-effectiveness. With equitable access to vaccination, antimicrobial therapy, and targeted screening, substantial reductions in infection-related cancer burden in Asia may be achievable.</p>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"73 ","pages":"101957"},"PeriodicalIF":9.4,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver cancer in Japan: epidemiological transition, viral hepatitis control, and emerging challenges.","authors":"Junko Tanaka, Ko Ko, Aya Sugiyama, Chanroth Chhoung, Akemi Kurisu, Masahiro Satake, Tatsuya Kanto, Takaji Wakita, Tomoyuki Akita","doi":"10.1016/j.lanwpc.2026.101900","DOIUrl":"10.1016/j.lanwpc.2026.101900","url":null,"abstract":"<p><p>Japan has seen a dramatic shift in liver cancer epidemiology, with hepatocellular carcinoma (HCC) declining after decades of comprehensive viral hepatitis control, illustrating the impact of sustained public health intervention. This review examines trends in liver cancer epidemiology in Japan in the context of long-term viral hepatitis control. National data indicate a substantial reduction in disease burden, with liver cancer mortality declining from 34,637 deaths in 2002 to fewer than 30,000 in 2014. The incidence of newly acquired infections is low, with HCV estimated at approximately 0.4 per 100,000 person-years and HBV at 2.38 per 100,000 person-years. These trends likely reflect population-based screening, universal health coverage, and expanded access to antiviral therapy. However, the aetiology of HCC is evolving, with non-viral causes increasing from 6.8% in 1991 to 41.1% in 2015 and accounting for 56.0% of HCC deaths in 2019. Overall, Japan's experience suggests progress in viral hepatitis control, while highlighting the need to address metabolic and lifestyle-related risk factors to sustain future prevention of liver cancer.</p>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"73 ","pages":"101900"},"PeriodicalIF":9.4,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From screening to surveillance: integrated prevention of <i>Helicobacter pylori</i>-associated gastric cancer in the Asia-Pacific region.","authors":"Jeesun Yoon, Do-Youn Oh","doi":"10.1016/j.lanwpc.2026.101958","DOIUrl":"10.1016/j.lanwpc.2026.101958","url":null,"abstract":"<p><p>Gastric cancer remains a significant cause of cancer-related morbidity and mortality in the Asia-Pacific region, where <i>Helicobacter pylori</i> infection is common and national cancer screening programs are widely implemented. Eradication therapy has been shown to reduce gastric cancer risk; however, residual risk persists in individuals with established precancerous changes. In addition, screening and surveillance practices vary across countries according to epidemiological and healthcare contexts. This review summarizes current approaches to the prevention continuum strategies of <i>H. pylori</i>-associated gastric cancer in the Asia-Pacific region. Drawing on representative national experiences, we discuss how screening, eradication, and post-eradication surveillance have been implemented across diverse epidemiologic and healthcare settings. By integrating these complementary strategies from infection to cancer care, we highlight the rationale for different national prevention models and the remaining challenges in gastric cancer control.</p>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"73 ","pages":"101958"},"PeriodicalIF":9.4,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epstein-Barr virus based biomarkers and targeted therapies in nasopharyngeal carcinoma: a narrative review.","authors":"Sen-Yu Feng, Ren-Jia Shu, Na Liu, Jun Ma","doi":"10.1016/j.lanwpc.2026.101852","DOIUrl":"10.1016/j.lanwpc.2026.101852","url":null,"abstract":"<p><p>Nasopharyngeal carcinoma (NPC) is a human malignancy with well-established association with Epstein-Barr virus (EBV) infection. Due to the concealed anatomical location of nasopharynx and the absence of early-stage clinical symptoms, most patients are diagnosed at a relatively advanced stage. EBV-related biomarkers, such as plasma EBV DNA and serum EBV antibodies, demonstrate outstanding sensitivity and specificity in the early detection of NPC. Moreover, plasma EBV DNA also serves as a useful tool for prognostic prediction of patients with NPC. Although current standard therapies have significantly improved the survival of patients with locoregionally advanced NPC, the establishment of personalized treatment plans remains challenging, and a subset of patients still experience disease progression even after definitive treatment. Plasma EBV DNA has shown great potential in guiding adaptive treatment of NPC, enabling optimum efficacy while minimizing treatment associated adverse effects. Additionally, EBV-targeted therapies, including cell therapies and small-molecule drugs activating anti-virus immune response or directly targeting EBV life cycle, represent promising approaches for these patients. In this review, we systematically summarized recent advances in EBV-targeted screening, prognostic prediction, adaptive treatment, and novel treatment strategies for NPC, discussed the strengths and limitations of these approaches and outlined future research directions in these fields.</p>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"73 ","pages":"101852"},"PeriodicalIF":9.4,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment utilisation for Aboriginal and Torres Strait Islander people diagnosed with prostate cancer in Australia: a population-based study.","authors":"Mei Ling Yap, Gabriel Gabriel, Joseph Descallar, Susan Anderson, Geoff P Delaney, Viet Do, Rebecca Murray, Karen Wong, Henry H Woo, Kalinda Griffiths, Keziah Bennett-Brook, Julieann Coombes","doi":"10.1016/j.lanwpc.2026.101931","DOIUrl":"10.1016/j.lanwpc.2026.101931","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer is the most common cancer diagnosed in Aboriginal and Torres Strait Islander men. Surgery and radiotherapy are curative options, with equivalent survival but different side effects and financial costs. We aim to determine the uptake of surgery and/or radiotherapy for prostate cancer by Aboriginal and Torres Strait Islander people within New South Wales (NSW).</p><p><strong>Methods: </strong>This was an individualised patient linked-data study which used the NSW Cancer Registry (2009-2018), NSW Admitted Patient Data Collection, Outpatient Radiation Oncology Data and Register of Births, Deaths and Marriages. Fine-Gray Competing Risk models were used to estimate cause-specific hazards for time to radiotherapy and time to prostatectomy with a competing risk of death.</p><p><strong>Findings: </strong>There were 59,621 people diagnosed with prostate cancer; 1061 (1.8%) were Aboriginal and Torres Strait Islander people. The median follow-up time was 6.3 years. A total of 22,946 (41.4%) patients received a prostatectomy; in Aboriginal and Torres Strait Islander people, it was lower at 362 (36.6%) patients. A total of 17,196 (31.0%) received external beam radiation therapy and for Aboriginal and Torres Strait Islander people, 349 (35.3%) received radiotherapy. In univariate analysis, Aboriginal and Torres Strait Islander people were less likely to receive a radical prostatectomy (HR 0.9, p < 0.05) than the rest of the population. However this association was lost when adjusting for possession of private insurance and comorbidities. Aboriginal and Torres Strait Islander people were more likely to receive radiotherapy on multivariable analysis (HR 1.2, p = 0.001).</p><p><strong>Interpretation: </strong>Aboriginal and Torres Strait Islander people are more likely to receive radiotherapy but less likely to receive surgery than the rest of the NSW population, with socio-economic factors associated with the treatment received. It is imperative there is equitable and affordable access to treatment options for Aboriginal and Torres Strait Islander people.</p><p><strong>Funding: </strong>This study was funded by the 2023 UNSW Health Systems Theme Collaborative grant.</p>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"73 ","pages":"101931"},"PeriodicalIF":9.4,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RNF213-related vasculopathy: beyond a linear “pre-moyamoya” model","authors":"Jayanta Roy,&nbsp;Ritwick Mondal,&nbsp;Shramana Deb,&nbsp;Julián Benito-León","doi":"10.1016/j.lanwpc.2026.101954","DOIUrl":"10.1016/j.lanwpc.2026.101954","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"73 ","pages":"Article 101954"},"PeriodicalIF":9.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148739432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National genomic survey of drug-resistance and multi-jurisdictional clusters of Mycobacterium tuberculosis in Australia 2015–2023","authors":"Jessica R. Webb,&nbsp;Eby Sim,&nbsp;Kristy Horan,&nbsp;Caitlin Selway,&nbsp;Patiyan Andersson,&nbsp;Susan Moss,&nbsp;Stanley Pang,&nbsp;Arnold Bainomugisa,&nbsp;Alireza Zahedi,&nbsp;Justin T. Denholm,&nbsp;Elena Martinez,&nbsp;Sushil Pandey,&nbsp;Maria Globan,&nbsp;Taryn Crighton,&nbsp;Ella M. Meumann,&nbsp;Dimitrios Menouhos,&nbsp;Robert W. Baird,&nbsp;Norelle L. Sherry,&nbsp;Karina Kennedy,&nbsp;Louise Cooley,&nbsp;Benjamin P. Howden","doi":"10.1016/j.lanwpc.2026.101928","DOIUrl":"10.1016/j.lanwpc.2026.101928","url":null,"abstract":"<div><h3>Background</h3><div>Tuberculosis is a global public health priority. In Australia, genomic analysis of <em>Mycobacterium tuberculosis</em> (<em>Mtb</em>) occurs at state or territory level, thus multijurisdictional genomics of <em>Mtb</em> remains poorly understood. We present the first national assessment of <em>Mtb</em> using nine years of genomic data from all Australian jurisdictions, as a part of the Australian Pathogen Genomics program.</div></div><div><h3>Methods</h3><div>Our national <em>Mtb</em> sequence dataset spanned 2015–2023 and represented culture-confirmed cases. AusTrakka was optimised to allow secure, national contribution of <em>Mtb</em> genomes and metadata. Drug resistance was determined using <em>tbtamr</em>, and genomic clusters were identified via hierarchical single linkage clustering (5 SNPs) from pairwise SNP distances. Criteria were established to identify clusters of national public health significance.</div></div><div><h3>Findings</h3><div>We analysed 6616 Mtb sequences, representing 59% of notified cases nationwide. Lineages 1–4 were detected, with lineage 2 the most prevalent and drug resistant. At the 5-SNP threshold, 373 genomic (17% of sequences) clusters were identified, with 48 (13%) clusters identified as nationally significant. Critically, 31 genomic clusters spanned multiple jurisdictions and persisted for &gt;5 years. Genomic analysis inferred low rates of <em>Mtb</em> drug resistance in Australia.</div></div><div><h3>Interpretation</h3><div>This first-of-a-kind study on genomic diversity of <em>Mtb</em> in Australia highlighted the benefits of national aggregation and analysis of <em>Mtb</em> sequencing data. It identified multi-jurisdictional clusters which, on average, persisted longer than clusters within jurisdictions. We also established the framework and infrastructure for implementing national coordination, detection, and surveillance of priority clusters to enhance tuberculosis control in Australia.</div></div><div><h3>Funding</h3><div>Australian National Health and Medical Research Council, Medical Research Futures Fund (FSPGN00049).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"73 ","pages":"Article 101928"},"PeriodicalIF":9.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148639337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atrial fibrillation in Australia, New Zealand, Malaysia, and Singapore: unmet needs and future priorities","authors":"Jonathan W.S. Ong,&nbsp;Melissa E. Middeldorp,&nbsp;Hanis Hanum Zulkifly,&nbsp;Norlizawati Moktar,&nbsp;Gregory Y.H. Lip,&nbsp;Chi Keong Ching","doi":"10.1016/j.lanwpc.2026.101941","DOIUrl":"10.1016/j.lanwpc.2026.101941","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"73 ","pages":"Article 101941"},"PeriodicalIF":9.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148639338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}