Martin-Moreno Jose M, Soerjomataram Isabelle, Magnusson Gudjon
Medical School and Clinical Hospital, University of Valencia, Avenida Blasco Ibanez, 15, 46010 Valencia, Spain.
Eur J Cancer. 2008 Jul;44(10):1390-403. doi: 10.1016/j.ejca.2008.02.002. Epub 2008 Mar 7.
The rising cancer burden in Europe, mainly due to a rapidly ageing population, demands a clear and coordinated response from researchers, oncologists and other physicians, public health professionals and policy-makers. Primary and secondary prevention is the front line in the complex battle against cancer in Europe. To formulate the best strategies in this fight, the major determinants of cancer are summarised in the order of their relative importance in Europe, including tobacco smoking, alcohol, diet, physical activity, occupational factors, environmental factors, infectious agents and genetic and hormonal factors. Furthermore, this paper offers explicit recommendations on individual behaviour modification and possible public policies. It also details the numerous examples of European policies and programmes already in effect which aim to reduce the impact of these risk factors on cancer. Although there are still pending questions, which need further epidemiologic research, it is also true that we have more operational knowledge for cancer prevention than ever before. The prompt implementation of prevention programmes such as those detailed here should be applied with determination to maximise the prevention results.
欧洲癌症负担不断上升，主要原因是人口迅速老龄化，这就要求研究人员、肿瘤学家和其他医生、公共卫生专业人员及政策制定者做出明确且协调一致的应对。一级和二级预防是欧洲抗击癌症这场复杂战斗的前沿阵地。为制定这场战斗的最佳策略，现将癌症的主要决定因素按照其在欧洲的相对重要性依次总结如下，包括吸烟、饮酒、饮食、身体活动、职业因素、环境因素、感染因子以及遗传和激素因素。此外，本文就个人行为改变和可能的公共政策提出了明确建议。还详细列举了欧洲已实施的旨在减少这些风险因素对癌症影响的众多政策和项目实例。尽管仍有一些悬而未决的问题需要进一步的流行病学研究，但我们在癌症预防方面拥有的可操作知识确实比以往任何时候都更多。应果断实施此处详述的预防项目，以最大限度地提高预防效果。
