Department of Gastroenterology, Changhai Hospital, Second Military Medical University (Naval Medical University), 168 Changhai Road, Shanghai, 200433, China.
Company Eleven, Students Brigade, Second Military Medical University (Naval Medical University), Shanghai, 200433, China.
Int J Public Health. 2018 Sep;63(7):811-821. doi: 10.1007/s00038-018-1131-5. Epub 2018 Jun 11.
This review assessed the complex longitudinal processes involved in cancer etiology during life course to understand how the social inequality may be embodied in and influence cancer risk.
A narrative literature review was performed with a keyword search conducted using PubMed, Scientific Electronic Library Online and Google. Three aspects of literatures were mainly included: social environmental mechanisms of cancer, life course of cancer development and social inequality of cancer risk. This review was complemented with manual searches of relevant journals and reference lists of primary articles.
Social inequality is mostly embodied in genetic susceptibility and early childhood development, the duration and intensity of exposures and the access to medical resources, which influence the timing and accumulation of cancer risk during life course.
The individuals with lower socioeconomic status are more likely to have higher cancer risk because of more frequency of timing and quantity of accumulation of adverse exposures and greater impact on epigenetic mechanisms. Primary prevention is the best prevention strategy to reduce cancer risk.
本综述评估了生命历程中癌症病因学所涉及的复杂纵向过程，以了解社会不平等如何体现在癌症风险中并影响癌症风险。
使用 PubMed、SciELO 和 Google 进行关键词搜索，进行了叙述性文献综述。主要包括文献的三个方面：癌症的社会环境机制、癌症发展的生命历程和癌症风险的社会不平等。本综述还补充了对相关期刊的手动搜索和主要文章的参考文献列表。
社会不平等主要体现在遗传易感性和儿童早期发育、暴露的持续时间和强度以及获得医疗资源方面，这些因素影响了生命历程中癌症风险的时机和积累。
社会经济地位较低的个体更有可能面临更高的癌症风险，因为他们面临更多的不利暴露的时机和数量的积累，并且对表观遗传机制的影响更大。初级预防是降低癌症风险的最佳预防策略。
