Wynder E L, Goodman M T, Hoffmann D
Carcinog Compr Surv. 1985;8:39-62.
The 1982 Report of the Surgeon General of the U.S. Public Health Service concluded that "cigarette smoking is the major single cause of cancer mortality in the United States" and that "85 percent of lung cancer cases are due to smoking". Thus, major emphasis should be placed on school health education programs designed to prevent young people from smoking. Those students who are already cigarette smokers should be provided with an opportunity to attend smoking cessation courses with the hope that they stop. However, as long as society condones tobacco usage, millions of people will smoke, and millions of others will be involuntarily exposed to tobacco smoke. In this communication we have discussed the need for future research on the etiology of lung cancer. This includes the observation of a shift toward an increasing proportion of adenocarcinoma compared to squamous cell carcinoma of the lung in men, more detailed knowledge of the effects of macro- and micronutrients in the etiology of lung cancer, a clear delineation of the impact of tumor initiators, tumor promoters, and cocarcinogens in the development of lung cancer in cigarette smokers, and a study of the effects of the low-yield cigarette on the lung cancer risk of smokers. Finally, we reviewed the present knowledge as to the possible association of passive smoke exposure and lung cancer. Here we have placed major emphasis on the need for a close cooperation between epidemiologists and clinical biochemists in risk assessment.
1982年美国公共卫生服务局局长的报告得出结论：“吸烟是美国癌症死亡的主要单一原因”，且“85%的肺癌病例归因于吸烟”。因此，应主要强调旨在防止年轻人吸烟的学校健康教育项目。应该为那些已经吸烟的学生提供参加戒烟课程的机会，期望他们能够戒烟。然而，只要社会容忍烟草使用，就会有数百万人吸烟，还有数百万人将不可避免地接触到烟草烟雾。在本交流中，我们讨论了未来肺癌病因学研究的必要性。这包括观察男性肺癌中腺癌与鳞状细胞癌比例不断增加的趋势，更详细地了解大量营养素和微量营养素在肺癌病因中的作用，明确界定肿瘤引发剂、肿瘤促进剂和协同致癌物对吸烟者肺癌发展的影响，以及研究低焦油香烟对吸烟者患肺癌风险的影响。最后，我们回顾了目前关于被动接触烟草烟雾与肺癌可能关联的知识。在此，我们主要强调了流行病学家和临床生物化学家在风险评估中密切合作的必要性。
