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识别与创建下一代基于社区的癌症预防研究:美国国立癌症研究所智库总结

Identifying and Creating the Next Generation of Community-Based Cancer Prevention Studies: Summary of a National Cancer Institute Think Tank.

作者信息

McCaskill-Stevens Worta, Pearson Deborah C, Kramer Barnett S, Ford Leslie G, Lippman Scott M

机构信息

Division of Cancer Prevention, NCI, Bethesda, Maryland.

Moores Cancer Center, UC San Diego Health, La Jolla, California.

出版信息

Cancer Prev Res (Phila). 2017 Feb;10(2):99-107. doi: 10.1158/1940-6207.CAPR-16-0230. Epub 2016 Dec 13.

Abstract

In late 2015, the NCI Division of Cancer Prevention convened cancer prevention research experts and stakeholders to discuss the current state of cancer prevention research, identify key prevention research priorities for the NCI, and identify studies that could be conducted within the NCI Community Oncology Research Program. Goals included identifying cancer prevention research opportunities offering the highest return on investment, exploring the concept of precision prevention and what is needed to advance this area of research, and identifying possible targets for prevention. Four study populations were considered for cancer prevention research: healthy people, those at increased risk for a specific cancer, people with preneoplastic lesions, and children, adolescents, and young adults. Priorities that emerged include screening (e.g., surveillance intervals, tomosynthesis vs. digital mammography), a pre-cancer genome atlas (PreTCGA), HPV vaccines, immunoprevention of noninfectious origins, and overdiagnosis. Challenges exist, as the priority list is ambitious and potentially expensive. Clinical trials need to be carefully designed to include and maximize prospective tissue collection. Exploring existing cofunding mechanisms will likely be necessary. Finally, relationships with a new generation of physician specialists will need to be cultivated to reach the target populations. Cancer Prev Res; 10(2); 99-107. ©2016 AACR.

摘要

2015年末,美国国立癌症研究所癌症预防部召集癌症预防研究专家和利益相关者,讨论癌症预防研究的现状,确定国立癌症研究所癌症预防研究的关键优先事项,并确定可在国立癌症研究所社区肿瘤学研究项目内开展的研究。目标包括确定投资回报率最高的癌症预防研究机会,探讨精准预防的概念以及推进该研究领域所需的条件,以及确定可能的预防靶点。癌症预防研究考虑了四类研究人群:健康人群、特定癌症风险增加者、癌前病变患者以及儿童、青少年和青年。出现的优先事项包括筛查(如监测间隔、断层合成与数字乳腺摄影)、癌前基因组图谱(PreTCGA)、人乳头瘤病毒疫苗、非感染性起源的免疫预防以及过度诊断。挑战依然存在,因为优先事项清单雄心勃勃且可能成本高昂。临床试验需要精心设计,以纳入并最大化前瞻性组织收集。可能有必要探索现有的共同资助机制。最后,需要培养与新一代内科专家的关系,以覆盖目标人群。《癌症预防研究》;10(2);99 - 107。©2016美国癌症研究协会。

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