Klein Eric A
Section of Urologic Oncology, Glickman Urological Institute.
Nat Clin Pract Urol. 2005 Jan;2(1):24-31. doi: 10.1038/ncpuro0072.
The goal of primary chemoprevention is to decrease the incidence of a given cancer, simultaneously reducing both treatment-related adverse events and mortality. Prostate cancer is an attractive and appropriate target for primary prevention because of its incidence, prevalence, and disease-related mortality; its long latency and molecular pathogenesis; and epidemiologic data indicating that modifiable environmental factors may decrease risk. The Prostate Cancer Prevention Trial (PCPT) demonstrated that finasteride can prevent prostate cancer, albeit with an apparently increased risk of high-grade disease. A substantial amount of epidemiologic, molecular, and clinical evidence suggests that both selenium and vitamin E might also prevent prostate cancer, and this combination is being tested in the Selenium and Vitamin E Cancer Prevention Trial (SELECT). Ultimately, the adoption of a preventive strategy hinges on its potential benefits weighed against the potential risks of the specific agents used.
一级化学预防的目标是降低特定癌症的发病率，同时减少与治疗相关的不良事件和死亡率。前列腺癌因其发病率、患病率和疾病相关死亡率；其较长的潜伏期和分子发病机制；以及表明可改变的环境因素可能降低风险的流行病学数据，成为一级预防的一个有吸引力且合适的目标。前列腺癌预防试验（PCPT）表明非那雄胺可以预防前列腺癌，尽管高级别疾病的风险明显增加。大量的流行病学、分子和临床证据表明，硒和维生素E也可能预防前列腺癌，这种组合正在硒和维生素E癌症预防试验（SELECT）中进行测试。最终，一种预防策略的采用取决于其潜在益处与所用特定药物潜在风险的权衡。
