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遗传学与环境对澳大利亚原住民癌症风险的影响:一篇叙述性综述。

The impact of genetics and the environment on cancer risk in Indigenous Australians: a narrative review.

作者信息

Nguyen Andrew D K, Meehan Katie, Redfern Andrew D, Brown Alex, Robinson Melanie, Papertalk Lenny, Thompson Sandra C

机构信息

Western Australian Centre for Rural Health, University of Western Australia, Geraldton, Western Australia, Australia.

Rural Clinical School, University of Queensland, Rockhampton, Queensland, Australia.

出版信息

Lancet Reg Health West Pac. 2025 Jun 29;61:101627. doi: 10.1016/j.lanwpc.2025.101627. eCollection 2025 Aug.

Abstract

Aboriginal and Torres Strait Islander (hereafter respectfully named Indigenous) Australians are diagnosed with some cancers substantially more frequently than non-Indigenous Australians implying a different risk factor landscape. Additionally, poorer outcomes for certain cancers are exacerbated by lower cancer screening rates and later diagnoses compared to non-Indigenous Australians. An improved understanding of cancer causation would allow better shaping and targeting of screening programs for those at the highest risk. A narrative review of relevant environmental and genetic risk factors for various cancers in Indigenous populations was undertaken. Research databases were interrogated in June 2024, with information extracted. Further peer-reviewed and grey literature was identified by specific searchers and citation snowballing. The results show that many distinct risk factors exist in environmental, sociocultural, educational, behavioural and metabolic domains; these complex and frequently interacting risks include direct and indirect social and cultural factors. Identified gaps include limited published literature on the genetic determinants of cancer, decreased levels of effective cancer surveillance for Indigenous Australians, a paucity of culturally appropriate cancer health education programs for both Indigenous community members and health providers, and the historical absence of an Indigenous Australian focus and contribution to research on cancer causation. Indigenous Australian co-designed research is needed to address the gaps contributing to cancer prevention and screening development. Empowerment of national Indigenous Australian leadership in partnership with researchers and service providers is needed to develop tailored health interventions and reduce the existing and future challenges of the cancer burden on Indigenous communities.

摘要

澳大利亚原住民和托雷斯海峡岛民(以下统称为原住民)被诊断出患某些癌症的频率比非原住民澳大利亚人高得多,这意味着风险因素情况有所不同。此外,与非原住民澳大利亚人相比,某些癌症的较差预后因癌症筛查率较低和诊断较晚而加剧。更好地了解癌症病因将有助于更合理地制定针对高危人群的筛查计划。对原住民人群中各种癌症的相关环境和遗传风险因素进行了叙述性综述。2024年6月对研究数据库进行了查询,并提取了信息。通过特定搜索和引文滚雪球法确定了更多经过同行评审的文献和灰色文献。结果表明,在环境、社会文化、教育、行为和代谢领域存在许多不同的风险因素;这些复杂且经常相互作用的风险包括直接和间接的社会和文化因素。已确定的差距包括关于癌症遗传决定因素的已发表文献有限、对澳大利亚原住民的有效癌症监测水平下降、缺乏针对原住民社区成员和医疗服务提供者的具有文化适宜性的癌症健康教育计划,以及历史上澳大利亚原住民在癌症病因研究方面缺乏关注和贡献。需要开展澳大利亚原住民共同设计的研究来弥补这些差距,以促进癌症预防和筛查发展。需要与研究人员和服务提供者合作,赋予澳大利亚原住民国家领导层权力,以制定量身定制的健康干预措施,并减少原住民社区现有和未来面临的癌症负担挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eec7/12414354/e70d562c87a8/gr1.jpg

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