Environmental and heritable factors in the causation of cancer - Analyses of cohorts of twins from Sweden, Denmark, and Finland.
Environmental and heritable factors in the causation of cancer - Analyses of cohorts of twins from Sweden, Denmark, and Finland.
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DOI：
10.1056/nejm200007133430201
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发表时间：
2000-07-13
影响因子：
158.5
通讯作者：
Hemminki, K
中科院分区：
文献类型：
--
作者：
Lichtenstein, P;Holm, NV;Hemminki, K
背景：遗传因素在散发性癌症发病中的作用尚不清楚。对双胞胎的研究使我们有可能估计遗传基因对恶性疾病发展的总体贡献。方法：我们结合瑞典、丹麦和芬兰双胞胎登记中列出的44,788对双胞胎的数据，以评估患有癌症的双胞胎在28个解剖部位的癌症风险。结果：在9512对双胞胎中，10803人中至少有一人发生了癌症。在受影响的人的双胞胎中发现患胃癌、结直肠癌、肺癌、乳腺癌和前列腺癌的风险增加。可遗传因素对前列腺癌(42%的风险可由遗传因素解释；95%可信区间为29%~50%)、结直肠癌(35%；95%可信区间10%至48%)和乳腺癌(27%；95%可信区间4%至41%)的影响具有统计学意义。结论：遗传因素对大多数类型肿瘤的易感性影响较小。这一发现表明，环境是导致散发性癌症的主要原因。少数部位(如前列腺癌和结直肠癌)的遗传性对癌症的影响相对较大，这表明我们对癌症的遗传学知识存在重大差距。(N Engl J Med 2000；343：78-85)(C)2000年，马萨诸塞州医学会。
Background: The contribution of hereditary factors to the causation of sporadic cancer is unclear. Studies of twins make it possible to estimate the overall contribution of inherited genes to the development of malignant diseases.Methods: We combined data on 44,788 pairs of twins listed in the Swedish, Danish, and Finnish twin registries in order to assess the risks of cancer at 28 anatomical sites for the twins of persons with cancer. Statistical modeling was used to estimate the relative importance of heritable and environmental factors in causing cancer at 11 of those sites.Results: At least one cancer occurred in 10,803 persons among 9512 pairs of twins. An increased risk was found among the twins of affected persons for stomach, colorectal, lung, breast, and prostate cancer. Statistically significant effects of heritable factors were observed for prostate cancer (42 percent of the risk may be explained by heritable factors; 95 percent confidence interval, 29 to 50 percent), colorectal cancer (35 percent; 95 percent confidence interval, 10 to 48 percent), and breast cancer (27 percent; 95 percent confidence interval, 4 to 41 percent).Conclusions: Inherited genetic factors make a minor contribution to susceptibility to most types of neoplasms. This finding indicates that the environment has the principal role in causing sporadic cancer. The relatively large effect of heritability in cancer at a few sites (such as prostate and colorectal cancer) suggests major gaps in our knowledge of the genetics of cancer. (N Engl J Med 2000;343:78-85.) (C) 2000, Massachusetts Medical Society.