Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts.
Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California.
Cancer Epidemiol Biomarkers Prev. 2017 Sep;26(9):1370-1380. doi: 10.1158/1055-9965.EPI-17-0459. Epub 2017 Jul 14.
A growing number and increasing diversity of factors are available for epidemiological studies. These measures provide new avenues for discovery and prevention, yet they also raise many challenges for adoption in epidemiological investigations. Here, we evaluate 1) designs to investigate diseases that consider heterogeneous and multidimensional indicators of exposure and behavior, 2) the implementation of numerous methods to capture indicators of exposure, and 3) the analytical methods required for discovery and validation. We find that case-control studies have provided insights into genetic susceptibility but are insufficient for characterizing complex effects of environmental factors on disease development. Prospective and two-phase designs are required but must balance extended data collection with follow-up of study participants. We discuss innovations in assessments including the microbiome; mass spectrometry and metabolomics; behavioral assessment; dietary, physical activity, and occupational exposure assessment; air pollution monitoring; and global positioning and individual sensors. We claim the the availability of extensive correlated data raises new challenges in disentangling specific exposures that influence cancer risk from among extensive and often correlated exposures. In conclusion, new high-dimensional exposure assessments offer many new opportunities for environmental assessment in cancer development. .
越来越多的因素可用于流行病学研究,其种类也日益多样化。这些方法为发现和预防提供了新途径,但在流行病学研究中采用这些方法也带来了许多挑战。在这里,我们评估了 1)用于研究疾病的设计,这些设计考虑了暴露和行为的异质和多维指标,2)用于捕捉暴露指标的众多方法的实施情况,以及 3)用于发现和验证的分析方法。我们发现病例对照研究为遗传易感性提供了一些见解,但不足以描述环境因素对疾病发展的复杂影响。需要采用前瞻性和两阶段设计,但必须平衡延长的数据收集与研究参与者的随访。我们讨论了评估方法的创新,包括微生物组;质谱和代谢组学;行为评估;饮食、体力活动和职业暴露评估;空气污染监测;以及全球定位和个人传感器。我们声称,广泛相关数据的可用性提出了新的挑战,即需要从广泛且通常相关的暴露中分离出影响癌症风险的特定暴露。总之,新的高维暴露评估为癌症发展中的环境评估提供了许多新机会。