School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, UK.
National Heart and Lung Institute, Hammersmith Campus, Imperial College London, London, W12 0NN, UK.
Arch Toxicol. 2022 Sep;96(9):2419-2428. doi: 10.1007/s00204-022-03324-z. Epub 2022 Jun 15.
Concern over substances that may cause cancer has led to various classification schemes to recognize carcinogenic threats and provide a basis to manage those threats. The least useful schemes have a binary choice that declares a substance carcinogenic or not. This overly simplistic approach ignores the complexity of cancer causation by considering neither how the substance causes cancer, nor the potency of that mode of action. Consequently, substances are classified simply as "carcinogenic", compromising the opportunity to properly manage these kinds of substances. It will likely be very difficult, if not impossible, to incorporate New Approach Methodologies (NAMs) into binary schemes. In this paper we propose a new approach cancer classification scheme that segregates substances by both mode of action and potency into three categories and, as a consequence, provides useful guidance in the regulation and management of substances with carcinogenic potential. Examples are given, including aflatoxin (category A), trichlorethylene (category B), and titanium dioxide (category C), which demonstrate the clear differentiation among these substances that generate appropriate levels of concern and management options.
对可能致癌的物质的担忧导致了各种分类方案的出现，以识别致癌威胁并为管理这些威胁提供依据。最无用的方案是做出二元选择，即宣布一种物质是否致癌。这种过于简单化的方法忽略了癌症成因的复杂性，既不考虑物质致癌的方式，也不考虑这种作用方式的效力。因此，物质只是被简单地归类为“致癌物质”，从而失去了妥善管理这些物质的机会。如果不是不可能的话，将新方法（NAMs）纳入二元方案也将非常困难。在本文中，我们提出了一种新的癌症分类方案，该方案根据作用方式和效力将物质分为三类，因此为具有致癌潜力的物质的监管和管理提供了有用的指导。给出了一些例子，包括黄曲霉毒素（A 类）、三氯乙烯（B 类）和二氧化钛（C 类），这些例子清楚地区分了这些物质，产生了适当程度的关注和管理选择。
