Austoker J
Department of Public Health and Primary Care, University of Oxford.
BMJ. 1994;309(6953):517-20. doi: 10.1136/bmj.309.6953.517.
Cancer control encompasses the whole spectrum from prevention and early diagnosis to treatment and palliation. The key to the future of cancer control will be to establish multidisciplinary approaches to each type of cancer across this spectrum. For primary prevention this requires some understanding of the causes of each cancer. Although understanding of the aetiology of cancer has greatly improved, prospects for the primary prevention of many common cancers remain remote. Other approaches currently under evaluation include chemoprevention and the use of biomarkers (discussed last week). The identification of predisposing genes for some of the common cancers may have a considerable impact on the ability to recognise those at risk. Overall, however, mortality trends indicate that reduction of smoking remains the main priority for cancer prevention in the United Kingdom. For primary care teams, brief interventions to reduce smoking are likely to achieve the greatest benefit. This should be seen as part of broader policies aimed at achieving change in the whole population. The government must acknowledge its major responsibility to cancer prevention by banning all forms of advertising and promotion of tobacco.
癌症控制涵盖了从预防、早期诊断到治疗和缓解的全过程。癌症控制未来的关键在于针对这一过程中每种类型的癌症建立多学科方法。对于一级预防，这需要对每种癌症的病因有所了解。尽管对癌症病因的认识有了很大提高，但许多常见癌症的一级预防前景仍然渺茫。目前正在评估的其他方法包括化学预防和生物标志物的使用（上周已讨论）。某些常见癌症易感基因的识别可能会对识别高危人群的能力产生重大影响。然而总体而言，死亡率趋势表明，减少吸烟仍然是英国癌症预防的首要任务。对于基层医疗团队来说，简短的戒烟干预措施可能会带来最大的益处。这应被视为旨在促使整个人口行为改变的更广泛政策的一部分。政府必须通过禁止所有形式的烟草广告和促销来承认其对癌症预防的主要责任。
