International Agency for Research on Cancer (IARC) 1976 Annual Report
International Agency for Research on Cancer (IARC) 1976 Annual Report
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国际癌症研究机构 (IARC) 1976 年年度报告
DOI：
10.1136/jcp.31.2.200
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发表时间：
1978
影响因子：
3.4
通讯作者：
F. J. Roe
中科院分区：
文献类型：
--
作者：
F. J. Roe
IARC的第一个10年IARC年度报告封面上的照片是里昂5年前的办公室和实验室，给人一种巨大的错觉。事实上，与其他癌症研究组织相比，IARC的工作人员不到二百人，1976年的预算只有六百多万美元，这是很小的，在评估它成立后的第一个十年的成就时，需要考虑到这一点。IARC的工作重点是在流行病学和地理癌症发病率数据的背景下适当地关注环境致癌作用。支持这一点的是10年来颁发的183项研究培训奖学金和228项旅行奖学金。如果IARC不是作为一个独立的组织成立的话，很难评估它所做的事情中有多少是不会做的。沿着同样的路线进行的工作，在国际癌症研究机构出现之前，由大英帝国癌症运动（现在的癌症研究运动）和各国的许多国家机构资助。即便如此，国际癌症研究机构对这些努力的协调具有非常真实的价值，无疑加快了进展。国际癌症研究机构关于评价化学品对人类致癌风险的系列专著，其中第13卷和第14卷刚刚出版，在若干方面具有价值。首先，它们的产生使来自不同国家的科学家聚集在一起，讨论与致癌风险评估有关的实验和流行病学数据的质量。因此，一些有关的科学家第一次意识到一些证据的模棱两可的性质。这反过来又导致了进一步的工作和普遍提高标准的实验。与此同时，这些专著为监管机构、癌症研究科学家和参与确定药物、农药、食品化学品和工业过程可能安全性的科学家提供了有用的参考来源。各论中提供的大多数化学品的实际评价没有它们可能的帮助，因为在没有人体数据的情况下（通常情况下），没有尝试判断动物试验的结果是否表明严重、中等或可忽略的危害。如果大多数被审查的物质都被排除了致癌的嫌疑，这就不会那么重要了，但事实并非如此。例如，在第13卷中考虑的17种药物中，有10种被认为在动物身上有明确的阳性结果，两种在动物身上有可疑的阳性结果，三种--非那西丁、羟甲烯龙和苯妥英--被指定为对人致癌，另外三种根本没有进行评价。没有一个是清白的。临床医生显然想知道这些药物是否有严重到足以影响他们处方模式的癌症风险。在实践中，专著对此没有提供有用的指导。在我看来，所审查的任何药物都不太可能构成严重的癌症危害，遗憾的是，这一点在该卷的导言或出版时的新闻稿中都没有明确说明。另一方面，该新闻稿确实包括一个充满智慧的限定性声明，值得全部复制：“在评估药物与癌症的关系时，除了药物本身可能导致癌症的可能性外，还应考虑以下因素：（1）病理状况可能导致癌症;（2）癌症可能导致病理状况;（3）药物本身可能导致癌症。
Thefirst 10years ofthe IARC The photograph on the front of IARC Annual Reports of the 5-year-old offices and laboratories at Lyon gives a false impression of great size. In fact, by com-parison with other cancer research organizations, the IARC with less than 200 staff and a budget in 1976 of only just over six million US dollars is small, and this needs to be borne in mind when assessing what it has achieved during the first 10 years of its existence. The emphasis of the IARC's efforts has appropriately been on environmental carcinogenesis against a background of epidemiological and geographical cancer incidence data. Backing this up has been the award during the 10 years of 183 research training fellowships and 228 travel fellowships. It is difficult to assess how much of what the IARC has done would not have been done if it had not come into existence as a separate organisation. Work along the same lines was being funded by the British Empire Cancer Campaign (now the Cancer Research Campaign) and by numerous national bodies in various countries before the IARC appeared on the scene. Even so, the coordination of such efforts by the IARC has been of very real value and undoubtedly hastened progress. The series of IARC monographs on the Evaluation of Carcinogenic Risk of Chemicals to Man, of which volumes 13 and 14 have just been published, have been of value in several ways. Firstly, their production has broughttogether scientists from different countries to discuss the quality of experimental and epidemio-logical data relevant to the evaluation of carcinogenic risk. As a consequence some of the scientistsconcerned haveappreciated for the first time the equivocal nature of some of the evidence. Thisin turn has ledto further work and to a general raising of standards of experimentation. At the same time the monographs have provided useful sources of reference for regulatory bodies, cancer research scientists, and scientists involved in determining the likely safety of drugs, pesticides, food chemicals, and industrial processes. The majority of actual evaluations of chemicals provided in the monographs are less helpful than they might have been because, where there are no human data (as is usually the case), no attempt is made to judge whether the results of animal tests indicate serious, intermediate, or negligible hazard. Ifmost of the substances reviewed had been cleared of suspicion of cancer hazard, this would not have mattered so much, but this is not the case. For instance, of the 17 drugs considered in volume 13, 10 are deemed to have given definitely positive results in animals and two doubtfully positive results in animals, three-phenacetin, oxymetholone, and phenytoin-are designated as being car-cinogenic to man, and a further three are not evaluated at all. None is cleared of suspicion. Clinicians would obviously want to know whether there is a cancer risk from any of these drugs serious enough to influence their prescribing patterns. In practice the monograph provides no useful guidance on this. In my opinion, it is unlikely that any of the drugs reviewed constitute a serious cancer hazard, and it is a pity that this is not stated clearly either in the introduction to the volume or in the press release that accompanied its publication. On the other hand, the press release does include a qualifying statement which is so full of wisdom as to be worth reproducing in toto:'When evaluating drug-cancer relation-ships, the following should be considered in addition to the possibility that the drug itself may cause cancer:(1) the pathological condition may predispose to cancer;(2) the cancer may predispose to the pathological condition;(3) the …