Palmer S
Cancer Res. 1983 May;43(5 Suppl):2509s-2514s.
The long latency period of cancer would suggest that timely measures to reduce the risk of cancer, such as dietary guidelines to the public, be an integral component of policy on cancer. Although criteria for acceptability of scientific evidence are often defined, judgment its required in interpreting the significance of the evidence when the data base is incomplete. This is often the case with knowledge concerning diet and chronic diseases including cancer. Similarly, judgment is required in applying scientific data to formulate public policy recommendations. The Committee on Diet. Nutrition, and Cancer of the National Academy of Sciences/National Research Council used generally accepted criteria in evaluating the literature and proposing interim dietary guidelines to reduce the risk of cancer. A comparison of these guidelines with advice rendered to the public by other private and government organizations reveals that there are substantial areas of consensus, but important differences persist among the various groups. One major philosophical difference concerns the validity of offering advice to the general public without complete demonstration of cause and effect or absolute proof of benefit. Particularly controversial is the recommendation to modify the intake of dietary fat and its components. The immediate future of dietary policy perhaps lies in capitalizing on the areas of consensus and exploring the feasibility of developing public health programs with realistic objectives.
癌症的潜伏期较长,这表明及时采取措施降低癌症风险,如向公众提供饮食指南,应成为癌症政策的一个组成部分。尽管科学证据可接受性的标准常常是明确的,但当数据库不完整时,在解读证据的重要性方面仍需要进行判断。在有关饮食与包括癌症在内的慢性病的知识方面,情况往往如此。同样,在应用科学数据来制定公共政策建议时也需要进行判断。美国国家科学院/国家研究委员会的饮食、营养与癌症委员会在评估文献并提出降低癌症风险的临时饮食指南时采用了普遍接受的标准。将这些指南与其他私人和政府组织向公众提供的建议进行比较后发现,存在大量共识领域,但不同群体之间仍存在重要差异。一个主要的理念差异涉及在没有完全证明因果关系或绝对证明益处的情况下向公众提供建议的有效性。关于调整膳食脂肪及其成分摄入量的建议尤其具有争议性。饮食政策的近期前景或许在于利用共识领域,并探索制定具有现实目标的公共卫生项目的可行性。