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胃肠道癌症在全球的兴起:是不健康的行为还是进步?

The Rise of Gastrointestinal Cancers as a Global Phenomenon: Unhealthy Behavior or Progress?

机构信息

Division of Worker's Health, Universidade Federal do Rio de Janeiro, Rio de Janeiro 22290-140, RJ, Brazil.

Departamento de Clínica Médica, Hospital Universitário, Universidade Federal do Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco 255, Ilha do Fundão, Rio de Janeiro 21941-913, RJ, Brazil.

出版信息

Int J Environ Res Public Health. 2023 Feb 18;20(4):3640. doi: 10.3390/ijerph20043640.

Abstract

The overall burden of cancer is rapidly increasing worldwide, reflecting not only population growth and aging, but also the prevalence and spread of risk factors. Gastrointestinal (GI) cancers, including stomach, liver, esophageal, pancreatic, and colorectal cancers, represent more than a quarter of all cancers. While smoking and alcohol use are the risk factors most commonly associated with cancer development, a growing consensus also includes dietary habits as relevant risk factors for GI cancers. Current evidence suggests that socioeconomic development results in several lifestyle modifications, including shifts in dietary habits from local traditional diets to less-healthy Western diets. Moreover, recent data indicate that increased production and consumption of processed foods underlies the current pandemics of obesity and related metabolic disorders, which are directly or indirectly associated with the emergence of various chronic noncommunicable conditions and GI cancers. However, environmental changes are not restricted to dietary patterns, and unhealthy behavioral features should be analyzed with a holistic view of lifestyle. In this review, we discussed the epidemiological aspects, gut dysbiosis, and cellular and molecular characteristics of GI cancers and explored the impact of unhealthy behaviors, diet, and physical activity on developing GI cancers in the context of progressive societal changes.

摘要

全球范围内癌症的总体负担正在迅速增加,这不仅反映了人口的增长和老龄化,还反映了风险因素的流行和传播。胃肠道(GI)癌症包括胃癌、肝癌、食管癌、胰腺癌和结直肠癌,占所有癌症的四分之一以上。虽然吸烟和饮酒是与癌症发展最相关的风险因素,但越来越多的共识还包括饮食习惯作为 GI 癌症的相关风险因素。目前的证据表明,社会经济发展导致了几种生活方式的改变,包括从当地传统饮食向不太健康的西方饮食的饮食习惯转变。此外,最近的数据表明,加工食品的产量和消费增加是肥胖和相关代谢紊乱当前流行的基础,这些与各种慢性非传染性疾病和胃肠道癌症的出现直接或间接相关。然而,环境变化不仅限于饮食模式,不健康的行为特征应该从生活方式的整体角度进行分析。在这篇综述中,我们讨论了 GI 癌症的流行病学方面、肠道菌群失调以及细胞和分子特征,并探讨了在社会变革的背景下,不健康的行为、饮食和体育活动对发展 GI 癌症的影响。

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