Haq Saba, Ali Shadan, Mohammad Ramzi, Sarkar Fazlul H
Department of Pathology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI 48201, USA.
Int J Mol Sci. 2012 Oct 1;13(10):12556-72. doi: 10.3390/ijms131012556.
Cancer epidemiology and prevention is one of the most well studied fields today. The more we can understand about the incidence and pathogenesis of this disease, the better we will be able to prevent it. Effective prevention strategies can decrease the mortality rate of cancer significantly; this is why it is important to delineate the underlying causes. It has been well recognized that genetic mutations, sporadic or hereditary, may lead to increased chance of tumorigenesis. Detecting genetic mutations can lead to the identification of high-risk individuals with hereditary cancer syndromes, which may assist in devising prevention strategies. Further, environmental factors are known to play important roles in epidemiology and suggest prevention tools that could be implemented to reduce cancer incidence and subsequent cancer-associated morbidity and mortality. Chemoprevention has been tried in colon cancer and is finding new advancements in other carcinomas as well. Out of many environmental cancer preventive agents, the most notable developments are the identification of the role of vitamins E, vitamin D and folic acid. Increased consumption of these vitamins has shown to be inversely correlated with cancer risk. This review will highlight important aspects of cancer epidemiology in the most aggressive carcinomas of the gastrointestinal system focusing on colorectal adenocarcinoma and pancreatic adenocarcinoma. Additionally, some of the well-known and evolving aspects of epidemiology of colorectal and pancreatic cancer along with current and new prevention strategies will also be reviewed.
癌症流行病学与预防是当今研究最为深入的领域之一。我们对这种疾病的发病率和发病机制了解得越多，就越能有效地预防它。有效的预防策略能够显著降低癌症死亡率；这就是明确潜在病因至关重要的原因。人们已经充分认识到，散发性或遗传性基因突变可能会增加肿瘤发生的几率。检测基因突变能够识别出患有遗传性癌症综合征的高危个体，这有助于制定预防策略。此外，已知环境因素在癌症流行病学中起着重要作用，并提示了一些可用于降低癌症发病率以及后续癌症相关发病率和死亡率的预防手段。化学预防已在结肠癌中进行尝试，并且在其他癌症中也取得了新进展。在众多环境癌症预防剂中，最显著的进展是确定了维生素E、维生素D和叶酸的作用。这些维生素摄入量的增加与癌症风险呈负相关。本综述将重点关注结直肠腺癌和胰腺腺癌，突出胃肠道系统最具侵袭性的癌症中癌症流行病学的重要方面。此外，还将回顾结直肠癌和胰腺癌流行病学中一些广为人知且不断发展的方面以及当前和新的预防策略。
