Viec c h i n dogn mi^c xgm l l n vg di can hgeh trgn CT cd y nghTa thye tidn vdi ngudi bdnh, nhd nhu'ng dgnh gig ngy mg phac dd d i l u trj dg thay ddi so vdi trudc khi chyp CT. Ddng thdi tidn luyng ciia bac s?
dli vdi nhung trudng hop ngy cQng vl thd mg thay ddi, Nhu vgy ehyp CT eho t h l y vide phgn tieh hlnh anh theo khdng gian ba chilu da cho phgp dgnh gig ro vg chinh xgc nhO'ng ton thuung u xgm ldn td ehO-c xung quanh, cae eu quan ian egn ddng thdi danh gia chidu eao, chilu rdng, bd ddy.
Dae biet cho phgp danh gia tdn thuong hgeh di can va xam l l n vdi dd dgc higu cao
Chup CT khdng gay khd ehiu, khdng ggy tdn thuong sang e h l n hay lai b i l n eho bdnh nhgn, nd gp dyng 3ugc cho tdt d mpi ddi l u y n g (trir phy nO' cd thai), mpi khdi u, d cac giai dogn khae nhau, kd ea cae tnrdng hyp khdi u ggy chit hgp, dpa ehay mau mg cgc can thi§p ehdn dogn bdng phuong phgp khge khdng tidn hgnh duyc Oge bigt ege khdi u d eao, khi thgm khgm tryc trgng khdng phat hidn duyc, hay nhu'ng trudng hyp hgeh di cgn d xa ma sigu gm khdng phat hign duye thi CT k h i c phye duyc nhO'ng
nhuyc didm dd, Ktl LUAN
Bdnh ly ung thu dgi tryc trang la ung thu hay gap, ehyp CT d byng cd bom thudc can quang dudng ITnh mgeh kdl hyp vdi thyt nude ed pha thudc cgn quang qua hgu mdn tryc trgng lg phuong phgp ehdn dogn duye vi tri, kieh thude, dge bigt d l i vdi nhO'ng trudng hyp cd di can, mCre dd xam l l n eOa khdi u eOng duyc phat hign
Day la phuong phap giCip Ieh trong vigc chdn dogn, dae bidt tl6n luyng tinh trgng ngudi bgnh, lya chpn phuong phgp didu tri phii hyp,
TAi LI$U THAM K H A O
1, Nguygn Duy Hud, Phgm Minh Thdng (2009).
Chdn dogn hlnh gnh, Nhg x u l t ban gigo dye Vigt Nam, Hg Nd|
2, Nguyen Khgnh Trgch, Pham Thi Thu Hd (1997), Ung thu dgi tryc trgng, Bgi gidng b§nh hpe ndi khoa, Nha xudt bgn y hpc, tap 1, tr 221 - 330.
3, Phgm Ngoc Hoa, Lg van Phudc (2007), CT byng vg chgu, Nha xult ban dai hpe qudc gia TP Ho Chl Minh, tr 2 4 5 - 2 7 9
Tir VONG DO UNG THlTTAI THANH PHO HAI PHONG, 2005-2007
LETRAN NGOAN - Trwdng D^i hgc YHd Npi TIWN QUOC BAO, PHAN TRONG LAN - Cue Yte dyphdng
TRAN THj OANH -BdYte LE HOAl CHUONG - Benh vidn Phu sin Trung wang v u TH! NGUY$T ANN - TT. Cham sdc sdc khde sinh sin Hd N6i
TOM T A T
Muc tidu: Md td thwc trang tw vong do ung thw theo ICD-10 vd gidi trong cgng ddng TP Hii Phdng, 2005-2007 Phwang phap: Thiit ki nghidn cdu vdn diJng phwang phip nghidn cdu md ti. Sd lieu dwac thu thdp bing 2 dgt diiu tm Idp vd phdn tich danh sdch td vong cic ndm 2005, 2006 vi 2007 do cic tnrdng Tram Y td xd hodn thdnh miu phiiu "Bdg cdo nguydn nhdn gdy td vong". Nghidn cdu dwgc trien khai tai 232 xd/phwdng thudc 14 qu$n/huydn cua TP Hai F'hdng. Tj Id td vong chuin hda/100.000 dwgc tinh theo ciu trdc din sd thi gidi. Ket qui: Ba loai ung thw phdi, gan vi da diy li nguydn nhin giy id vong cho 72,3% nam vd 61,6% nd ung thw. Tj lg td- vong do tit cd cic logi ung thw chuin hda theo tudi d nam vd nd ttrang Ong Id 183,1/100.000 vd 94.0/100.000. Ung thw bi tw vong cao nhit li phdi (ASR 60,2/100.000 a nam vi 27,7/100.000 d nw); thd nhi Id gan (ASR 46,2/100.000 d nam vi 14,2/100.000 dnd); thdba li dg diy (ASR 26,0/100.000 dnam vi 15,5/100.000 d nd). Kit ludn: Ung thw Id nguydn nhan td vong quan trgng cho ci 2 gidi vi nam bi ung thw cao han 1,9 lin nd.
Td khda: Td vong do ung thw, didu tm cdng ddng, dw phdng vd djch te hgc ung thw
SUMMARY
Cancer mortality in Hai Phong City, 2005-2007 Objectives: To desenbe cancer mortality by ICD-10 and sex in genemi population of Hai Phong City, 2005- 2007. Methods Descriptive epidemiology was applied for the study design. Data was collected by two munds to generate and analyse the lists of cases for year 2005.
2006 and 2007 which wem developed by tiie head of commune health stations applying the validated form of
"Mgrtality registmtion". The study was pertonned at 232 communes of 14 districts of Hai Phong City. Age- standardized mortality rate per 100.000 v/as estimated in using the Worid population stmcture. Results' Three cancer sites of lung, liver and stomach wem msponsible for 72.3% of mate and 61.6% of Ornate cancer Age- standardized mortality rates In males and females wem 183.0/100.000 and 94.0/100.000 mspectively. The leading cancer was lung (ASR 60 2/100.000 in male and 27.7/100.000 in female); followed by sliver (ASR 46.2/100.000 in male and 14.2/100000 in female) and stomach (ASR 26.0/100.000 in male and 15.5/100.000 in female). Conclusions: Cancer mortality was a senous pmblem in both sexes with mate to female ratio was 1 9 Keywords: Cancer mortality, population-based sun/ey, cancer epidemiglggy and pmvention
V HOC THV'C HANH (872) - SO 6/2013
DAT V A N o e
Md hinh bgnh tgt d nude ta hign nay la mdt md hinh kdp bao ^ d m bgnh truydn nhidm va cae bdnh khdng lay nhigm nhu tim mgch, ung thu, dgi thao dudng va bgnh p h l i t i c nghgn mgn tinh ,. Dgc bidt Irong nhO'ng n5m g i n dgy ty Ig m i c ung thu dang gta tang nhanh ehdng. Theo sd ligu thing kd tgi Hg Ndi, Thgnh phd Hd Chl Minh vg mdt sd tinh khgc, udc llnh mdi nam nude ta ed khodng 100.000 ngudl mdi m i c ung thu, 75,000 ngudi ehdt vi ung Ihu va con sd ngy ed xu hudng gla tang [1],[2], Ung thu da vd dang trd thgnh v i n de Idn cua cdng ddng vg y td cdng cdng.
Vide tim h i l u tinh hinh t u vong do bgnh ung thu d nudc ta s6 ddng gdp tieh eye eho vigc ey t h i hda kd hogch, dua ra djnh hudng uu tign eho cge hogt ddng phdng, ehdng ung thu trong hoan cdnh thyc td cua Vidt Nam, TP Hdi Phdng lg thgnh p h i cgng hgng trgm ngm nay, nggnh cdng nghidp ddng tau, xi mgng, vgl liSu xay dung, hda hpc va cae xl nghidp nhd phat t h i n d d trung tgm thgnh phd vg cge huy^n. NhCrng dae didm ngy Igm cho mOi trudng sdng thay d l i va Igm gia tSng cgc ydu t l nguy co m i c ung thu, Tuy nhidn, cho tdl nay, cd rdt ll cae edng trinh nghign ciru vd tCr vong do ung thu d TP Hdi Phdng d u y c thyc hi0n. Do vgy, chung tdi t i l n hanh dd tai nay vdi myc tidu: Md ta thuc trgng lir vong do ung thu theo ICD- 10 va gidi trong cdng ddng TP Hal Phdng trong egc nam 2005, 2006 va 2007.
D 6 | TU'ONG VA PHU'ONG P H A P
1. Odi t u o n g nghien cfru: Doi tuyng nghidn ciru la eae trudng hyp ti> vong do ung thu tai TP. Hai Phdng, trong giai doan 3 nam 2005-2007, tinh theo Duong lich lir 01/01/2005 d i n 31/12/2007.
-Tigu chudn chpn, Benh nhan d u y c e h l n doan mdc ung thu va ung thu lg nguyen nhSn chinh gay tCr vong, duye ma nguyen nhgn theo ICD-10 lg COO- C96. Benh nhgn la ngudi eiia TP Hai Phdng theo dign thudng tnJ, ho$e mdi chuyen den nhung da sinh s i n g trgn 6 thang d TP Hai Phdng.
- Tidu chudn logi trCr, (i) cge trudng hyp t u vong d TP, Hai Phdng trong ege ngm 2005-2007 ed nguygn nhgn ehinh khdng do ung thu, (ii) cge trudng hyp cd nguygn nhgn chinh lg ung thu nhung da ehuyin di khdi TP, Hai Phdng trdn 6 thgng hoae la ngudi ciia tinh khae den sinh sdng tgi TP, Hal Phdng dudi 6 thgng; (ili) NhCrng trudng hyp m i c ung thu nhung nguyen nhgn tir vong chinh Igi do tai ngn thuong tich hogc cgc bgnh khgc,
2. Dja didm vg thd-i gian t r i l n khai: Nghign cCru duyc tnen khai tgi TP Hai Phdng trdn phgm vi loan bd 232 xg/phudng cua 14 quan/huy$n vdi tdng dan sd la 1,803.400 ngudl (Sd iieu ngm 2006[1]) Thdi gian thu thap so ligu duyc thuc hidn hai ldn Ldn thCr nhit trong nam 2007 cho dilu tra cac trudng hyp t u vong cua hai nam 2005-2006, l l n thir 2 trong nam 2008 cho d i l u tra cgc trudng hop tir vong cua nam 2007.
3. T h i l t kg nghien cO-u; Van dyng phuong phap djch lg hoc md la doi vdi tO vong do ung thu (Descriptive Epidemiology),
4. Chpn m l u : MSu nghign CO'U la loan bd cgc trudng hyp tii' vong do ung thu. Quy trinh ehpn mlu nhu sau:
- Chpn cgc xa/phudng (Don vi mSu) ed s l li$u ghi nhan t u vong t i t theo cac tidu chi, (i) Ty Id tCr vong thd cua t i t cd cgc nguydn nhgn t h l p nhdt Id 300/100,000; (ii) Dgn sd khdng qug Idn, dudi 16.000 dan; (iii) Ghi c h i p d u y c cac nguygn nhan \d vong trdn 60% trong danh sach d i l u tra duyc.
- TCr cae xg/phudng d u y c chpn: Chpn togn b$
cae trudng hyp t u vong do ung thu giai dogn 2005- 2007 dua vao nghign cO-u.
Thdi gian ghi nhdn ung thu: Trong 3 nam tCr 2005 ddn 2007
5. Cdng ey va p h u o n g phdp thu t h ^ p s o l l f u : Sir dgng mdu phidu "Bao eao nguygn nhdn tfr vong" theo mliu sd A6-YTCS fll thu thgp thdng tin, d i l u tra nguydn nhgn Id vong vd lap danh sgch cdc trudng hyp tCr vong. Mdu phidu bao ego nguygn nhgn tir vong duye trinh bay trong t d A3 d hai m|t va ed 3 phdn:
- Phdn thdng tin hdnh chinh' Sd dan taing binh cOa tirng xg/phudng d u y c thu thdp theo tirng ngm tif 2005-2007, tdng sd vg ndng eho tCmg gidi. Dgn s6 trung binh d dgy ig 'Dgn sd Y te', bdi vi s l li$u ndy tinh cho loan bd sd dgn thudng tni, ngudi tgm tni nhung da s i n g trgn 6 thang trong i^a bgn nghign cOu, ngudl tgm v i n g dudi 6 thgng v i n tinh la ngudi thu6c dja phuong tham gia nghign euu. Cae thdng tin ve trgm Y td xa/phudng duoc thu thgp d l xae i^nh dja dii vg kiem tra sd lidu eho tirng Inrang hup t u vong do ung thu. Hp yg tdn cgn bd thdng ke nguyen nhgn tip vong theo mgu sd A6-YTCS, sd di#n thoai duyc thu thap dd phye vy cho cdng tgc k i l m tra sd li$u.
- Phgn hudng d i n cgch thu thap sd lieu: Dli vin tCrng trudng hyp t u vong do ung thu vg khdng do ung thu (Cgc nguygn nhan khgc) duyc hudng din ghi nguygn nhgn tu vong chinh theo ICD-10. Odi vdi t i t ca cge trudng hyp tir vong tir trd so sinh d^n ngudi trgn 70 tudi d u y e ghi rd hg va t6n, tuli lOc ti>
vong, theo gidi nam hoae nO', ngay, thang, nam ti>
vong vg ghi rd nguygn nhan h o l e tdn b$nh tryc ti^p gay tCr vong, Odi vdi ngudi bj t u vong do ung thir, trong cdt s i n g sd (5) phal ghi rd ung thu gi, vl du- ung thu phdi - p h i quan, ung thu mang phil, ungthif gan, ung thu dg dgy, ung thu dai trang, ung thu trirc trang, ung thu thye quan, ung t h u tyy, ung thu mdu, ung thu cd lir cung, ung thu vO, ung thu budng tn>ng, ung thu t i l n ll$l t u y i n , ung thu nao... D l i vdi ngirb'i li> vong do cae bgnh khae, trong edt sdng s l (5) phai ghi ro tgn b#nh ey the (Trgnh ghi nguyen nhSn ttf vong khdng rd rang nhu: gia ydu, ehdt gia, b6nh, gia , ) theo mau sau.
TT (1) 1 2
HqvS (21
Tu6i luc ch4t
(3)
Ngdy. thdng.
ndm ch^t (4)
Nguydn nhdn Oik (Tdn b$nh clli ti^l)
( 5 ) :•
<*
PhAn ghl danh sSch tu- vong du'p'c tao bangslfl 5 cOt nSy, trinh b i y lai trang 2-3-4 cda philu JiBJ
Y H Q C T H V C HANH (872) - SO MHO
tra k h i gidy A3. M l u phidu ghi d u y c 100 trudng hop, n l u xS/phud-ng nao ed danh sgch Idn hun 100, dOng 2 t d eho didu tra
Mdu phidu bgo eao nguygn nhan tu- vong duoe d p eho egc trgm y td xa/phudng vg do cgn bd trgm y td aa duye tap h u i n chju trach nhidm d i l u tra, thu Ihap va didn thdng tin Cge mdu philu sau khi hoan thanh duye S d Y td TP Hdi Phdng phdi hyp vdi nhdm nghidn eCru tdng hyp va phgn tieh theo 2 dyt cho cge nam 2005-2006 vg 2007. Cae phidu dugc kiem tra, gigm sgi vi egc tnj'dng hyp nghi ngd hole khdng rd sg duyc d i l u tra, xae minh Igi.
6. PhSn tich s d l i ^ u : Phdn mdm thdng kg Exeell 2009 va STATA 10.0 3ugc diing eho nhgp sd li$u vg phgn tieh s l li§u. Ba chi sd 3ugc tinh eho nghign cii'u nay lg ty lg% tCr vong do ung thu theo mg ICD-10 so vdi tdng sd ung thu; ty 1$ tCr vong thd/100.000 vg ty Id chuin hda Vneo d u triic dgn sd thd gidi (Age- standradized rate, ASR), d u trOe t u l i egeh 10 nam, lir 1-9 va eao nhdt la 80+, Ddi vdi ty Id thd va ASR/100.000, m l u sd lg s6 "Ngudi-nam", bdi vi danh sgch tCr vong tich IQy trong 3 ngm, s l dgn cOa tu'ng xa/phudng cOng duoe nhgn vdi 3 (Nam) cho sd ngudl-ngm
K^T QUA
Cd 128/232 xg/phudng ed sd lidu lidn tue ba nam 2005-2007 dat tigu ehi lg don vj cd s l lidu tdt, duyc phan tfch vg trinh bay k i t q u i cho nghien ciru nay.
Sd ngudi-nam cua 128 xa/phudng ed tdng so 1.432.475 la nam vd 1.490.944 la nO- va sd luyng theo nhdm tudi va gidi trinh bay trong thgp dgn s l d Hlnh 1,
Nam 143Z475 NO' 1490944 Hinh 1. Phan b6 s6 ngudi-nSm theo gidi vd nh6m tuii
Bang 1. S l luonq v g t v l g ICr vonq/100.000 theo qidi vg nhdm ICD-10 Ung thu
Vijnq tigu hgnq V6m honq Thyc quan Da day Dai - tfvc trSnq
Gan Tgy MiJi xoanq Thanh quan Phoi Tim Xirunq
Da Trunq bi^u mo
M6 lien ket Vu Co-ttiSn tu" cunq
Buonq tru'nq Sinh dgc nam
Thgn Bgnq c]uanq
MSt Ngo Tuyen nOi tilt
MAu Khgc T6nq
ICD-10 COO-14 C I I C15 C16 C18-20
C22 025 C30-31
C32 033-34 037-38 040-41 043-44 045 C46-49
C50 C53-55
C56 C60-63 C64-68 067 069-72
071 073-75 081-96
Nam S6
23 166 36 334 95 592 10 3 8 798
17 51 3 2 1 1
32 9 14 4 87 1 65 31 2 383
Ty le tho/
100 000 1,6 11,6 2,5 23.3
6,6 41,3
0,7 0,2 0,6 55,7
1.2 3.6 0,2 0,1 0,1 0,1
2.2 0,6 1.0 0,3 6,1 0.1 4,5 2,2 166,4
%
1.0 7,0 1,5 14,0 4,0 24,8 0,4 0,1 0,3 33,5 0,7 2,1 0,1 0,1 0,0 0.0
1,3 0,4 0,6 0,2 3,6 0.0 2,7 1,3 100
ASR /100.000
1,7 13,8 3.0 26.0
7,2 46,2
0.7 0.3 0,7 60,2 1,2 4,0 0.2 0,2 0,1 0,1
2,1 0.6 1,0 0,3 6,6 0,1 47 2,4 183,1
S i 8 42 9 216
79 196 12 3 1 396
6 26 7 3 49 85 4 12 6 2 38 94 19 1 313
NO Ty Ig tho/
100,000 0,5 2,8 0.6 14,5 5,3 13,1 0.8 0.2 0,1 26,6 0.4 1.7 0,5 0,2 3.3 5,7 0,3 0.8 0,4 0,1 2.5 6,3 1,3 88.1
%
0,6 3.2 0.7 16,5 6,0 14,9 0.9 0,2 0,1 30.2 0.5 2,0 0,5 0,2 3.7 6,4 0,3 0.9 0,5 0,2 2,9 7.2 1,4 100
ASR /100.000
0.6 3.0 0.6 15,5 5,5 14,2 0,9 0.2 0,1 27.7 0.4 1.9 0,4 0,2 3,7 6,4 0,3 0.8 0,4 0,2 2.6 7,0 1,5 94,0 Nhan xdt: Tdng s6 ehung cho hai gidi ed 3.696 trudng hop ung thu cua 25 nhdm nguyen nhan theo ICD- 10, trong dd sd trudng hyp d nam vd nu tuong ii'ng lg 2.383 vg 1.313. Ba logi ung thu phoi, gan va dg dgy la nguyen nhgn gay tCr vong ehidm 72,3% sd tir vong do ung thu d nam vg 61,6% d nu-. Ty le tir vong do tat ca cge loai ung thu ehuin hda theo tudi d nam vg nO- tuong Crng la 183,1/100.000 va 94,0/100.000, Ung thu bi tu vong cao nhdt la phdi (ASR 60,2/100.000 d nam va 27,7/100.000 d nu'), thir nhi la gan (ASR 46,2/100 000 d
Y HQC THVC H A N H (872) - SO 6/2013
nam va 14,2/100,000 d nO'), thir ba la dg dgy (ASR 26,0/100.000 d nam vd 15,4/100.000 d nO-). Nam bi ti>
vong do ung thu cao hon 1,9 l l n so vdi nO-,
B i n g 2 Ung thu d H l i Phdng vg mdt s l nude trong khu vyc Qudn thd vd thd'i gian
Hal Phdng, 2005-07 Nhdt Ban, 2002 Trungjau6c. 2002
Philippines, 2002 Singapore. 2002 Thailand, 2002
Nam Tyid thd/100.000
166.4 303.5 154.0 86.7 166.9 97,9
Ty Id chudn (ASR/100 000)
183,1 154,3 159,8 150,9 161,3 119,7
NC '-i T} Id thd/100.000
88,1 187,4 92,5 85,8 126,8 72,7
Ty Id chudn ^ (ASR/100,00011'
94,0 IS 82.2 S 86.7 » 123,7 ..i 108,7 .1
79,3 Nhgn xgl' Nam ed ty Ig t u vong thd t h l p hon so
vdi Nhgt B i n , luong duong Singapore, nhung cao hon Trung Qude, Philipines vg Thgi Lan; ty Ig chuin hda ASR cao hon cge nudc k l trgn, NO- cd ty Id t u vong thd thdp hun so vdi Nhat B i n , Trung Qudc vg Singapore, nhung eao hon Philipines vg Thai Lan; ly 1^ ehuin hda ASR t h l p hon Singapore vg Philipines.
BAN LUAN
Bgnh nhan ung thu d u y c ghi nh^n d loan bd cac xa/phudng trong dign nghign euu, trong dd ed eae phudng thude vimg dd thi tgi cae qugn ndi thanh va eae xg vung ndng thdn eua cgc huydn lg noi mdi trudng sdng chua bj tae ddng do edng nghidp va dd thi hda. Sy phgn bd ung thu d egc viing dia d u nhu vgy goi y nguygn nhan vg nguy ca ggy ung thu dang tdn tai trong mdi trudng sdng cd nui khdng lign quan ddn d nhidm cdng nghidp hay cgc logi d nhidm khgc, Hien tuung nay goi y c i n nghign ciru eae tae nhan/ylu to nguy co gay ung thu trong mdi trudng sdng tai cac gia dinh, thdn xdm cua cae dia phuong de cdng tae phdng bdnh ed hi$u qua hun.
Dge dilm ndi bgt lg ung thu p h l i , gan vg dg day lg ba loai ed ty le ggy t u vong cao n h l l cho ca hai gidi.
Tdng ty lg% ba logi ung thu ngy ggy tir vong d nam va nu" tuong i>ng la 72,3% va 61,6%; ty Id tir vong chuin hda theo tudi d nam, 183,1/100,000 vg d nir:
94,0/100.000. Ung thu phdi lg nguygn nhgn phd b i l n nhat d ca hai gidi, trong dd ty Id d nam cao hon n y 3- 4 l l n . Dieu ngy ed the d u y c giai thich la do ed tdi 50- 73% nam gidi va chl cd 2 ^ % nO' gidi hiit thude trong nhu'ng nam 1990-2005(3],[4] Hi§n tuyng ung thu phli phd b i l n d nO' gidi ed t h i la do hiit thulc thy ddng. Vi vgy giam ty Ig hOt thulc lg, thudc iao sg giam ty Id m i c va lu' vong do ung thu p h l i Ung thu gan vg ung thu da dgy lign quan nhilu yeu td, trong do ed yeu td nhilm triing do vidm gan B, vidm gan C va Helicobacter pylori[5],[6]. Trong tuung lai, vide sir dung vac xin vjdm gan B phd bidn hon vg didu trj lodt dg dgy do nhilm trung Helicobacter pylon tdl hon se giam m i c va l u vong do hai logi ung Ihu nay d d hai gidi 6 ' T P Hai Phdng, nam m i e ung thu cao hun 1,9 l l n so vdi nO", ty xult ngy nhd hon 2 d cgc nude khae trong khu v y c Nhat Ban 1,9, Trung Qudc 1,8, Philippines 1,2, Singapore 1,5 vg Thailand 1,5 (Bang
2). K i t qug ngy gyi y kha ngng phdng mdt mic ung thu cho nam gidi lg khg thi khi chiing la nghign ci>u phat hidn nguy eo gay ung t h u cho nam gidi vg kilm sogt cgc y l u td ngy thanh edng.
Mdt sd hgn ehd cua nghign ei>u. Bgnh nhan ti>
vong do ung thu khdng cd s6 lidu vd gidi phdu bSnh Cd t h i cd hidn tuyng chua ghi nhdn hit, bd sdt dc trudng hyp tir vong do ung t h u do cdng tae ghi chgp thdng kg ehua tdt d mdt sd trgm y t l xa/phudng, hoge egn bd chuyin cdng tae, hoae m i t sd thing kg nguygn nhgn tu' vong A6-YTCS.
K^T LUAN
Ba logi ung thu phdi, gan vg dg dgy la nguyen nhgn ggy t u vong eho 72,3% nam vg 61,6% nO' ung thu, Ty Ig tir vong do tat d cgc logi ung thu chuin hda theo tuoi /100.000 d nam vg n u tuung irng Id 183,1 vg 94,0, Ung thu bj tu' vong cao nhit lg phoi (ASR 60,2/100.000 d nam va 27,7/100.000 d nir), thir nhi la gan (ASR 46,2/100,000 d nam vk 14,2/100.000 d nu); t h u ba la dg dgy (ASR 26,0/100,000 d nam vg 15,4/100,000 d nu), Ung thu la nguyen nhan tU' vong quan trpng eho d 2 gidi vS nam bi ung thu eao hun 1,9 Idn nCr.
TAI LIEU THAM K H A O
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Y HOC THlTC HANH (872) - SO 6/2013
