Time to revisit Geoffrey Rose: strategies for prevention in the genomic era?
Time to revisit Geoffrey Rose: strategies for prevention in the genomic era?
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DOI：
10.2427/8665
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发表时间：
2012-01-01
影响因子：
--
通讯作者：
Zimmern, Ron L.
中科院分区：
文献类型：
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作者：
Burton, Hilary;Sagoo, Gurdeep S.;Zimmern, Ron L.
杰弗里·罗斯（Geoffrey Rose）在他的文章“患病个体和患病人群”中强调需要区分针对人群的预防和针对高危人群的预防。在本文中，我们根据有关“个性化医疗”的新兴文献以及我们对个性化癌症预防的调查结果重新审视其中一些概念，这是欧盟激素相关癌症基因环境研究（协作肿瘤基因环境研究（COGS））的一部分。我们建议可以修改罗斯的高风险策略，通过按风险（在我们的示例中为遗传风险）将人群细分为多个单独的层，每个层都可以应用差异化干预措施。我们称之为“分层预防”，并认为这种方法将在效率、有效性和危害最小化方面带来相应的优势。
Geoffrey Rose, in his article "Sick individuals and sick populations" highlighted the need to distinguish between prevention for populations and prevention for high risk individuals. In this article we revisit some of these concepts in light of the burgeoning literature on "personalised medicine" and of findings from our investigations into personalised cancer prevention as part of an EU research gene-environment study on hormone related cancers, the Collaborative Oncological Gene-environment Study (COGS). We suggest that Rose's high risk strategy may be modified by segmenting the population by risk (in our example genetic risk) into a number of individual strata, to each of which differential interventions may be applied. We call this "stratified prevention", and argue that such an approach will lead to consequential advantages in efficiency, effectiveness and harm minimisation.