Imperial College NHS Healthcare Trust, Hammersmith Hospital, London W12 0HS, United Kingdom; email:
Mailman School of Public Health, Columbia University, New York, NY 10032, USA; email:
Annu Rev Public Health. 2018 Apr 1;39:153-168. doi: 10.1146/annurev-publhealth-040617-014158. Epub 2017 Nov 20.
Over the past decade, precision medicine (PM) approaches have received significant investment to create new therapies, learn more about disease processes, and potentially prevent diseases before they arise. However, in many ways, PM investments may come at the expense of existing public health measures that could have a greater impact on population health. As we tackle burgeoning public health concerns, such as obesity, and chronic diseases, such as cancer, it is not clear whether PM is aligned with public health or in conflict with its goals. We summarize the areas of promise demonstrated by PM, discuss the limitations of each of these areas from a population health perspective, and discuss how we can approach PM in a manner that is congruent with the core aims of public health.
在过去的十年中,精准医学(PM)方法得到了大量投资,以创造新的疗法,更深入地了解疾病过程,并有可能在疾病出现之前进行预防。然而,在许多方面,PM 的投资可能会牺牲现有的公共卫生措施,而这些措施可能对人口健康产生更大的影响。当我们应对不断涌现的公共卫生问题,如肥胖和癌症等慢性病时,尚不清楚 PM 是否与公共卫生一致,还是与公共卫生的目标相冲突。我们总结了 PM 所展示的有前景的领域,从人口健康的角度讨论了这些领域的局限性,并讨论了我们如何以符合公共卫生核心目标的方式来处理 PM。