Perera F P
Division of Environmental Health Sciences, Columbia University School of Public Health, 60 Haven Avenue, B-1, New York, NY 10032, USA.
Science. 1997 Nov 7;278(5340):1068-73. doi: 10.1126/science.278.5340.1068.
Acting in concert with individual susceptibility, environmental factors such as smoking, diet, and pollutants play a role in most human cancer. However, new molecular evidence indicates that specific groups-characterized by predisposing genetic traits or ethnicity, the very young, and women-may have heightened risk from certain exposures. This is illustrated by molecular epidemiologic studies of environmental carcinogens such as polycyclic aromatic hydrocarbons and aromatic amines. Individual genetic screening for rare high-risk traits or for more common, low-penetrant susceptibility genes is problematic and not routinely recommended. However, knowledge of the full spectrum of both genetic and acquired susceptibility in the population will be instrumental in developing health and regulatory policies that increase protection of the more susceptible groups from risks of environmental carcinogens. This will necessitate revision of current risk assessment methodologies to explicitly account for individual variation in susceptibility to environmental carcinogens.
与个体易感性共同作用的是，吸烟、饮食和污染物等环境因素在大多数人类癌症中都起作用。然而，新的分子证据表明，以遗传易感性特征或种族、幼儿和女性为特征的特定群体，可能因某些暴露而面临更高风险。多环芳烃和芳香胺等环境致癌物的分子流行病学研究就说明了这一点。针对罕见的高风险特征或更常见的低外显率易感基因进行个体基因筛查存在问题，且通常不被推荐。然而，了解人群中遗传和后天易感性的全貌，将有助于制定健康和监管政策，加强对更易感群体的保护，使其免受环境致癌物风险的影响。这将需要修订当前的风险评估方法，以明确考虑个体对环境致癌物易感性的差异。
