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口腔癌最新进展:流行病学趋势、预防策略以及诊断和预后的新方法。

An update on oral cavity cancer: epidemiological trends, prevention strategies and novel approaches in diagnosis and prognosis.

机构信息

MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, UK.

University of Bristol Dental School, University Hospitals Bristol and Weston NHS Foundation Trust, UK.

出版信息

Community Dent Health. 2022 Aug 30;39(3):197-205. doi: 10.1922/CDH_00032Gormley09.

Abstract

In the UK, the incidence of oral cavity cancer continues to rise, with an increase of around 60% over the past 10 years. Many patients still present with advanced disease, often resulting in locoregional recurrence and poor outcomes, which has not changed significantly for over four decades. Changes in aetiology may also be emerging, given the decline of smoking in developed countries. Therefore, new methods to better target prevention, improve screening and detect recurrence are needed. High-throughput 'omics' technologies appear promising for future individual-level diagnosis and prognosis. However, given this is a relatively rare cancer with significant intra-tumour heterogeneity and variation in patient response, reliable biomarkers have been difficult to elucidate. From a public health perspective, implementing these novel technologies into current services would require substantial practical, financial and ethical considerations. This may be difficult to justify and implement at present, therefore focus remains on early detection using new patient-led follow-up strategies. This paper reviews the latest evidence on epidemiological trends in oral cavity cancer to help identify at risk groups, population-based approaches for prevention, in addition to potential cutting-edge approaches in the diagnosis and prognosis of this disease.

摘要

在英国,口腔癌的发病率持续上升,在过去 10 年中增加了约 60%。许多患者仍处于晚期疾病,常导致局部区域复发和预后不良,这四十多年来并没有显著改变。鉴于发达国家吸烟人数的减少,病因的变化也可能正在出现。因此,需要新的方法来更好地针对预防、改善筛查和检测复发。高通量“组学”技术似乎为未来的个体水平诊断和预后提供了前景。然而,鉴于这是一种相对罕见的癌症,具有显著的肿瘤内异质性和患者反应的变化,可靠的生物标志物一直难以确定。从公共卫生的角度来看,将这些新技术应用于当前的服务需要考虑到大量的实际、财务和伦理问题。目前,这可能难以证明和实施,因此仍将重点放在使用新的以患者为中心的随访策略来进行早期检测上。本文综述了口腔癌的最新流行病学趋势证据,以帮助确定高危人群,预防的基于人群的方法,以及该疾病诊断和预后的潜在前沿方法。

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