Behavioral Research Program, National Cancer Institute, Rockville, Maryland.
Behavioral Research Program, National Cancer Institute, Rockville, Maryland.
Am J Prev Med. 2014 Mar;46(3):303-11. doi: 10.1016/j.amepre.2013.10.004.
Human behavior is central to the etiology and management of cancer outcomes and presents several avenues for targeted and sustained intervention. Psychosocial experiences such as stress and health behaviors including tobacco use, sun exposure, poor diet, and a sedentary lifestyle increase the risk of some cancers yet are often quite resistant to change. Cancer screening and other health services are misunderstood and over-utilized, and vaccination underutilized, in part because of the avalanche of information about cancer prevention. Coordination of cancer care is suboptimal, and only a small fraction of cancer patients enroll in clinical trials essential to the development of new cancer treatments. A growing population of cancer survivors has necessitated a fresh view of cancer as a chronic rather than acute disease. Fortunately, behavioral research can address a wide variety of key processes and outcomes across the cancer control continuum from prevention to end-of-life care. Here we consider effects at the biobehavioral and psychological, social and organizational, and environmental levels. We challenge the research community to address key behavioral targets across all levels of influence, while taking into account the many new methodological tools that can facilitate this important work.
人类行为是癌症发病机制和治疗结果的核心，为有针对性和持续的干预提供了多种途径。心理社会体验，如压力，以及包括吸烟、过度日晒、不良饮食和久坐不动的生活方式等健康行为，增加了某些癌症的风险，但这些行为往往很难改变。癌症筛查和其他卫生服务被误解和过度利用，而疫苗的使用则不足，部分原因是有关癌症预防的信息铺天盖地。癌症治疗的协调并不理想，只有一小部分癌症患者参加了对开发新癌症治疗方法至关重要的临床试验。越来越多的癌症幸存者需要将癌症视为一种慢性而不是急性疾病，这是一个新的观点。幸运的是，行为研究可以解决从预防到临终关怀的癌症防治连续体中各种关键过程和结果。在这里，我们考虑了在生物行为和心理、社会和组织以及环境层面的影响。我们向研究界提出挑战，要求其解决所有层次影响下的关键行为目标，同时考虑到许多可以促进这项重要工作的新方法学工具。
