来源：《卫报》
原文刊登日期：2020年12月1日
Substantial improvement in the early detection of cancers was among the key aims set out last year in NHS England’s long-term plan. Although survival rates have been improving, it has long been recognised that too often they lag behind the best performing countries in Europe. Late diagnosis is widely recognised as being among the causes, since cancers found early are far more susceptible to treatment. Against this backdrop, last week’s announcement that a new blood test is to be trialled on 165,000 people from next year, in the hope that it will help identify early-stage cancers, is an exciting development.
去年，英国国民健康服务体系（NHS）制定了一项长期计划，其中一项关键目标是大幅改善癌症的早期检测。尽管癌症患者存活率一直在提高，但人们早就认识到，存活率往往落后于欧洲表现最好的国家。晚期诊断被广泛认为是原因之一，因为早期发现的癌症更容易治疗。在这种背景下，上周宣布的一项新的血液测试将从明年开始在16.5万人身上进行试验，希望它能帮助识别早期癌症，这是一个令人兴奋的进展。
The test, known as Galleri, looks for abnormal DNA, and is most likely to have an impact on those cancers – including lung, ovarian and pancreatic – that are typically diagnosed late, and for which there is currently no screening programme. Another UK study using blood tests created by the same US healthcare company, Grail, to detect lung cancer, is already under way. As ever with research, there are no guarantees, and NHS England has a mountain to climb: currently just 55% of cancers are diagnosed at stages 1 or 2. The aim is to reach 75% by 2028. But at the end of a year that has placed the NHS under huge strain, it is encouraging that some of the pledges in the long-term plan may be on the way to being met.
这项被称为Galleri的检测旨在寻找异常DNA，最有可能对包括肺癌、卵巢癌和胰腺癌在内的癌症有效果，这些癌症通常诊断较晚，目前还没有筛查计划。英国的另一项研究也在进行中，该研究使用的是同一家美国医疗保健公司Grail的血液测试来检测肺癌。和以往一样，研究效果没有保证，英格兰国民保健服务有一座山要爬：目前只有55%的癌症在1或2阶段被诊断出来。目标是到2028年达到75%。但是，在让NHS承受巨大压力的一年即将结束之际，令人鼓舞的是，长期计划中的一些承诺可能即将兑现。
Things will very likely get worse before they get better. Earlier this year, Cancer Research UK estimated that 2.1 million people across Britain were waiting for cancer screening appointments that had been postponed due to the pandemic. The fear is that many thousands of cases may have gone undiagnosed, or become inoperable.
情况很可能会在好转之前变得更糟。今年早些时候，英国癌症研究中心估计，全英国有210万人在等待因疫情而推迟的癌症筛查预约。令人担心的是，成千上万的病例可能没有得到诊断，或者无法手术。
Yet this has been an extraordinary year for medical science – as well as for disease. The development of not just one, but three vaccines, all of which appear to be effective against Covid-19, is remarkable. That two of these represent a dramatic departure in the field of vaccine research, since they employ a new technique involving injecting the virus’s mRNA, opens up the possibility that the boost given to research by the pandemic could bring longer-term benefits.
然而，对于医学和疾病来说，今年都是非凡的一年。不是一种疫苗，而是三种疫苗，似乎都对新冠病毒有效，这是值得注意的。有两种疫苗代表了疫苗研究领域的重大转变，因为它们采用了注射病毒信使rna的新技术，这开启了一种可能性，即新冠大流行对研究的推动可能带来长期效益。
Scientific breakthroughs on their own do not solve all our health problems. Just as vaccine scepticism and the logistics of distribution must be tackled as part of the pandemic response, so public attitudes – including a reluctance among some groups to seek treatment – must form part of any cancer strategy. Simon Stevens, the chief executive of NHS England, warned recently that an “epidemic of obesity”, which is linked to 13 cancers, risks undoing the progress made on reducing smoking. Obesity is closely linked to poverty. These are more than caveats; it does not make sense to view health in isolation from other aspects of public policy. But still, the prospect of a new and relatively non-invasive cancer screening test, is one reason for hope.
科学突破本身并不能解决我们所有的健康问题。正如疫苗怀疑论和分发后勤问题必须作为应对大流行的一部分加以解决一样，公众的态度——包括一些群体不愿寻求治疗——也必须成为任何癌症战略的一部分。英国国民保健服务(NHS)首席执行官西蒙•史蒂文斯最近警告称，与13种癌症有关的“肥胖流行病”，有可能毁掉在减少吸烟方面取得的进展。肥胖与贫困密切相关。这些不仅仅是警告；把健康与公共政策的其他方面分开来看是没有意义的。但是，一种新的、相对非侵袭性的癌症筛查方法的前景，仍然是我们有希望的原因之一。