Toporcov Tatiana N, Wünsch Filho Victor
Departamento de Epidemiologia, Faculdade de Saude Publica, Universidade de Sao Paulo, Sao Paulo, SP, BR.
Clinics (Sao Paulo). 2018 Sep 21;73(suppl 1):e627s. doi: 10.6061/clinics/2018/e627s.
Epidemiological methods are essential for the discovery of cancer risks and prognostic factors as well as for the evaluation of cancer prevention measures. In this review, we discuss epidemiological surveillance procedures for data collection and processing to guide and evaluate the consequences of anticancer efforts for populations, assess the identification of cancer risk factors, examine barriers to cancer screening and recommended rules for early diagnosis programs. Epidemiological studies have shown that hindrances to cancer information assessment are currently encountered in developing countries. Known cancer risk factors include social determinants, lifestyle factors, occupational exposures, infectious agents, and genetic and epigenetic alterations. Challenges remain in studying the effectiveness of cancer screening; screening can have detrimental effects, and few cancers clearly benefit from screening. Currently, epidemiology faces the challenge of dealing with distinct levels of data, including factors related to social status, lifestyle and genetics, to reconstruct the causal traits of cancer. Additionally, translating epidemiological knowledge into cancer control demands more implementation studies in the population.
流行病学方法对于发现癌症风险和预后因素以及评估癌症预防措施至关重要。在本综述中,我们讨论用于数据收集和处理的流行病学监测程序,以指导和评估抗癌努力对人群的影响,评估癌症风险因素的识别,审视癌症筛查的障碍以及早期诊断项目的推荐规则。流行病学研究表明,发展中国家目前在癌症信息评估方面存在障碍。已知的癌症风险因素包括社会决定因素、生活方式因素、职业暴露、感染因子以及遗传和表观遗传改变。在研究癌症筛查的有效性方面仍存在挑战;筛查可能会产生有害影响,而且很少有癌症能明显从筛查中受益。目前,流行病学面临着处理不同层面数据的挑战,包括与社会地位、生活方式和遗传学相关的因素,以重构癌症的因果特征。此外,将流行病学知识转化为癌症控制需要在人群中开展更多实施研究。