The big three concept: a way to tackle the health care crisis?
The big three concept: a way to tackle the health care crisis?
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DOI：
10.1513/pats.200806-058th
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发表时间：
2008-12-01
期刊：
影响因子：
--
通讯作者：
Gerhardsson de Verdier, Maria
中科院分区：
文献类型：
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作者：
Gerhardsson de Verdier, Maria
烟草使用是世界上可预防的主要死亡和发病原因。慢性阻塞性肺疾病（COPD）、肺癌和心血管疾病（CVD）是三种主要的吸烟引起的疾病，它们共存，可以通过筛查在早期发现，但通常在晚期被识别并作为单一实体治疗。新的流行病学数据表明，这些疾病在易感个体中的共同起源，以及潜在的疾病修饰。进一步探索三大吸烟引起的疾病-COPD，肺癌和CVD-的整体概念可能是减轻个人和社会疾病负担的一种方法。这包括从反应性到主动性的重新转变。因此，未来的治疗和管理方法应侧重于疾病预防。在这篇文章中，提出了三大概念，其目的是（1）识别易感吸烟者;（2）筛查早期诊断;（3）开发针对共同疾病机制的新治疗方式，从而有可能影响一种以上的合并症;（4）提高对这些共存疾病的认识，并修改当前的跨专业指南。
Tobacco use is the leading preventable cause of death and morbidity in the world. Chronic obstructive pulmonary disease (COPD), lung cancer, and cardiovascular disease (CVD) are the three major smoking-induced diseases that co-exist and can be detected at an early stage by screening, but are usually recognized in an advanced stage and treated as single entities. New epidemiologic data indicate a common origin of these diseases in susceptible individuals, and potential disease modification. Further exploration of a holistic concept of the Big Three smoking-induced diseases-COPD, lung cancer, and CVD-may be one way of reducing the burden of illness for individuals and society. This includes a reshift from reactivity to proactivity. Future treatment and management approaches should thus be focused on disease prevention. In this article, the Big Three concept is suggested, which aims for (1) identification of susceptible smokers; (2) screening for early diagnosis; (3) development of new treatment modalities that target shared disease mechanisms, thus having the potential to affect more than one of the comorbidities; and (4) increased awareness of these co-existing diseases and modification of current guidelines across specialties.