Preventive therapy for cancer
Preventive therapy for cancer
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DOI：
10.1016/s1470-2045(17)30536-3
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发表时间：
2017-08-01
期刊：
影响因子：
51.1
通讯作者：
Cuzick, Jack
中科院分区：
文献类型：
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作者：
Cuzick, Jack
治疗性癌症预防是一个发展中的领域，可以从预防心血管疾病的成功中获益匪浅。虽然体重控制和体育活动对预防这两种疾病都很重要，但还有其他一些预防措施。低剂量阿司匹林预防癌症通常被认为是最重要的方法，应提供给50岁以上没有高血压或胃肠道出血风险因素的人。针对人乳头瘤病毒的普遍疫苗接种，理想的是九价疫苗，如果在感染发生之前（即通常在12-14岁）给予，也为整个人群提供了实质性的益处。其他疗法，如用于预防乳腺癌的抗雌激素药物，应针对高危人群，以保持有利的获益风险比。更好的识别算法和改进的平台，以达到这些群体，如在筛查访问期间，仍然是一个关键的优先事项，使现有的知识，以告知公共卫生。许多其他有前途的化合物已被确定，通常作为食物的组成部分，但结果表明，β胡萝卜素和维生素E的管理增加疾病的发病率表明，这种治疗需要严格的评估之前接受。
Therapeutic cancer prevention is a developing area that can gain a lot from the successes in the prevention of cardiovascular diseases. Although weight control and physical activity are important in the prevention of both diseases, several other preventive measures exist. Low-dose aspirin for cancer prevention is often cited as the most important approach in terms of population benefit, and should be offered to those older than 50 years of age without hypertension or risk factors for gastrointestinal bleeding. Universal vaccination against the human papillomavirus, ideally with the nine-valent vaccine, also offers substantial benefits for the whole population if given before infection occurs (ie, typically at age 12-14 years). Other therapies, such as anti-oestrogen drugs for breast cancer prevention, should be targeted to high-risk groups to maintain a favourable benefit-risk ratio. Better algorithms for identification and improved platforms to reach these groups, such as during a screening visit, remain a key priority to allow existing knowledge to inform public health. Many other promising compounds have been identified, often as components of food, but results suggesting increased disease incidence with beta carotene and vitamin E administration indicate that such treatments need rigorous evaluation before acceptance.