慢性病防治現況與未來

Chronic Disease Prevention: Present and Future

非傳染性疾病（non-communicable diseases, NCDs）近年來成長快速已成為全球重大健康威脅，根據世界衛生組織（World Health Organization, WHO）2014年全球非傳染病報告，非傳染病已佔全球死亡人數之68%，更重要其中超過40%為70歲以下的過早死亡。我國衛生福利部2017年國人十大死因統計，癌症佔有28%、心血管疾病22.3%，糖尿病5.7%及慢性呼吸道疾病3.6%，這四大非傳染性疾病，也幾乎佔了國人死亡原因的6成，呼應非傳染病（NCDs）成為全球重大健康威脅疾病的現狀。台灣面臨戰後嬰兒潮的老化狀態，由於老化與慢性病是一體兩面，2013年國民健康署的調查發現8成以上的老人至少有一種以上的慢性病，共病的情形嚴重。本文應用公共衛生三段五級說明慢性病整體防治，以利照護同仁了解減少慢性病危險因子及透過篩檢早期發現早期治療相關政策，並對未來整體照護提出系統性架構。 Non-communicable diseases (NCDs) have risen to become a major threat to health worldwide. According to the World Health Organization, NCDs accounted for 68% of all global mortality in 2014, with over 40% of NCD-related mortality incidents defined as premature deaths under the age of 70 years. Among the top-10 causes of death named by the Taiwan Ministry of Health and Welfare in 2017, 28% were cancers, 22.3% were cardiovascular diseases, 5.7% were diabetes, and 3.6% were chronic obstructive pulmonary diseases. These four major NCDs currently account for nearly 60% of all mortalities in Taiwan and reflect the threat of NCDs to global health. Taiwan's increasingly ageing society faces an increasing risk of NCDs, which threatens the health and wellbeing of Taiwan's population. A survey by the Health Promotion Administration in 2013 found that over 80% of senior citizens in Taiwan are afflicted with one or more NCD and that the presence of a comorbidity further exacerbates the problem of living and coping with NCDs. This article introduces the primary, secondary, and tertiary public health prevention measures related to NCDs in order to help caregivers better understand the importance of reducing the risk factors of NCDs and of screening to promote early detection and treatment. This article further proposes a systemic framework for the future care of NCDs.