Gu Kyle J, Li Guojun
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
College of Natural Sciences, The University of Texas at Austin, Austin, TX, USA.
J Cancer Prev. 2020 Sep 30;25(3):127-135. doi: 10.15430/JCP.2020.25.3.127.
Cancer prevention encompasses a broad spectrum of strategies designed to lower the chance of developing cancer and reduce the morbidity of established cancer. There are three levels of cancer prevention. Eliminating or mitigating cancer risk factors by adopting healthy behaviors and lifestyles, such as avoiding tobacco and alcohol use, exercising, eating a healthy diet, and applying sunscreen to protect against UV exposure, belongs to primary prevention and is the easiest and most effective way of preventing cancer for the general public. Secondary prevention includes screening to identify precancerous lesions and taking intervention measures to prevent disease progression to malignancy. Tertiary prevention refers to reducing or controlling the symptoms and morbidity of established cancer or the morbidity caused by cancer therapy. For high-risk populations, chemopreventive agents, such as selective estrogen receptor modulators (including tamoxifan and raloxifene) in breast cancer prevention and non-steroidal anti-inflammatory drugs (aspirin) in colorectal cancer prevention, and immunoprevention using human papillomavirus and hepatitis B virus vaccines in infection-related cancers have shown clear clinical benefits of reducing cancer incidences. In this review, we will summarize the current status of cancer prevention, focusing on the major agents that are clinically used for chemoprevention and immunoprevention.
癌症预防涵盖了广泛的策略，旨在降低患癌几率并减少已确诊癌症的发病率。癌症预防有三个层面。通过采取健康的行为和生活方式来消除或减轻癌症风险因素，比如避免吸烟饮酒、锻炼身体、保持健康饮食以及涂抹防晒霜以防止紫外线照射，这属于一级预防，是普通大众预防癌症最简单且最有效的方式。二级预防包括筛查以识别癌前病变，并采取干预措施防止疾病发展为恶性肿瘤。三级预防是指减轻或控制已确诊癌症的症状和发病率，或减轻癌症治疗所导致的发病率。对于高危人群，化学预防剂，如用于预防乳腺癌的选择性雌激素受体调节剂（包括他莫昔芬和雷洛昔芬）以及用于预防结直肠癌的非甾体抗炎药（阿司匹林），还有在与感染相关癌症中使用人乳头瘤病毒和乙肝病毒疫苗进行免疫预防，都已显示出在降低癌症发病率方面有明确的临床益处。在本综述中，我们将总结癌症预防的现状，重点关注临床上用于化学预防和免疫预防的主要药物。
