文章：

癌症预防的未来方向

Future directions in cancer prevention

原文发布日期：2012-11-15

DOI: 10.1038/nrc3397

类型: Review Article

开放获取: 否

要点：

1. In the past three decades, the approach to cancer prevention has moved from population and epidemiological studies to molecular targeting and immunological approaches and to identifying high-risk pre-cancerous lesions in individuals using emerging early detection technologies.
2. Global implementation of these scientifically-sound lifestyle- and medical-based cancer prevention strategies has the potential to reduce worldwide cancer incidence, prevalence and mortality rates in the decades ahead.
3. As more is learned about the mechanisms and pathways that are influenced by genetic and molecular changes that initiate cancer or encourage its progression, targeted therapies are being developed to interrupt these processes. Additional strategies are specifically focused on interrupting the late-stage, but still pre-malignant, processes that lead to in situ cancers, with the goal of averting progression to actual invasive cancer.
4. The success of vaccines for human papilloma virus (HPV)- and hepatitis B virus (HBV)-related cancers has led to an increased focus on immunologically based research for many other cancers. Efforts are ongoing to develop immune response modulation strategies to augment the innate immunity and to develop vaccines against oncogenic infectious agents, as well as tumour-associated and tumour-specific antigens.
5. The groundwork for the future of cancer prevention is currently being developed through multidisciplinary initiatives that involve researchers from tradition biology-based laboratories, as well as collaborators from the fields of information technology, imaging technologies, '-omics' (such as genomics, proteomics and metabolomics) and communication. Expertise in communication is essential to disseminate research findings to the communities that are likely to benefit from these findings. Inherent to this future progress is a focus on precision (individualized) medicine that will include identifying those who are at a high risk of developing cancer.

要点翻译：

1. 在过去的三十年中，癌症预防方法已从群体流行病学研究转向分子靶向与免疫学方法，并通过新兴早期检测技术识别个体的高风险癌前病变。
2. 在全球范围内实施这些科学合理的生活方式及医学基础癌症预防策略，有望在未来几十年降低全球癌症发病率、患病率和死亡率。
3. 随着对引发癌症或促进其发展的遗传和分子变化所影响的机制与通路了解加深，针对这些过程的靶向疗法正在不断开发。更多策略专门着眼于阻断导致原位癌的晚期（但仍属癌前阶段）病变过程，以阻止其发展为实际浸润癌。
4. 针对人乳头瘤病毒（HPV）和乙型肝炎病毒（HBV）相关癌症的疫苗成功研发，推动了对多种其他癌症免疫学研究的关注。当前持续致力于开发免疫调节策略以增强先天免疫力，并针对致瘤性传染源、肿瘤相关及肿瘤特异性抗原研发疫苗。
5. 癌症预防未来的基础工作正通过多学科合作推进，参与者不仅来自传统生物学实验室，还包括信息技术、影像技术、“组学”（如基因组学、蛋白质组学、代谢组学）及传播学领域的合作者。传播专业知识对于将研究成果传递给潜在受益群体至关重要。这一未来进展的核心在于精准（个体化）医疗，重点包括识别癌症高风险人群。

英文摘要：

Prevention of cancer remains the most promising strategy for reducing both its incidence and the mortality due to this disease. For more than four decades, findings from epidemiology, basic research and clinical trials have informed the development of lifestyle and medical approaches to cancer prevention. These include selective oestrogen receptor modulators and aromatase inhibitors for breast cancer, the 5-α-reductase inhibitors finasteride and dutasteride for prostate cancer, and the development of vaccines for viruses that are associated with specific cancers. Future directions include genetic, proteomic and other molecular approaches for identifying pathways that are associated with cancer initiation and development, as well as refining the search for immunologically modifiable causes of cancer.

摘要翻译： 

癌症的预防仍然是降低其发病率和由此疾病导致的死亡率最有前景的策略。四十多年来，来自流行病学、基础研究和临床试验的发现为生活方式和医学方法在癌症预防中的发展提供了依据。这些包括用于乳腺癌的选择性雌激素受体调节剂和芳香化酶抑制剂，用于前列腺癌的5-α-还原酶抑制剂非那雄胺和度他雄胺，以及针对与特定癌症相关的病毒开发的疫苗。未来的方向包括遗传学、蛋白质组学和其他分子方法，用于识别与癌症起始和发展相关的途径，以及完善对癌症免疫学可调节原因的寻找。

原文链接：

Future directions in cancer prevention