Modan B
Isr J Med Sci. 1981 Sep-Oct;17(9-10):804-9.
Descriptive data demonstrate a marked variation in the incidence of breast cancer in distinct populations, which is closely linked to socioeconomic status and correlated with a differential age-specific incidence pattern and time trends. These suggest a westernization effect, and the possible existence of two distinct disease entities--pre- and postmenopausal. Known risk factors may be defined in a number of ways. From a preventive standpoint, a practical classification is suggested whereby risk factors are grouped as preventable, modifiable, unapproachable or spurious. The only risk factors which seem definite at present are estrogen exposure, family history and radiation, with the possible contribution of benign breast disease, replacement hormones, and diet. The only preventable factors are radiation and possibly long-term hormonal replacement, but their contribution to the disease indicence in the population is minimal. Two theoretically modifiable factors are diet and age at first birth, but the latter cannot be easily influenced, and the effect of dietary modification is still unsubstantiated.
描述性数据表明，不同人群中乳腺癌的发病率存在显著差异，这与社会经济地位密切相关，并与特定年龄发病率模式和时间趋势的差异相关。这些表明了一种西方化效应，以及可能存在两种不同的疾病实体——绝经前和绝经后。已知的风险因素可以通过多种方式定义。从预防的角度来看，建议进行一种实用的分类，据此将风险因素分为可预防、可改变、无法触及或虚假的。目前看来确定的唯一风险因素是雌激素暴露、家族史和辐射，可能还有良性乳腺疾病、替代激素和饮食的影响。唯一可预防的因素是辐射以及可能的长期激素替代，但它们对人群中疾病发病率的贡献极小。理论上有两个可改变的因素是饮食和初产年龄，但后者不易受到影响，而且饮食改变的效果仍未得到证实。
