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[背景]每年,全球新发癌症近1300万例,癌症死亡760万例;63%的癌症死亡病例发生在中、低收入国家。有相当比例的癌症是由环境和工作场所中致癌物暴露所致。[目的]为环境和职业性癌症的一级预防制定基于循证的全球愿景和战略。[方法]通过在PubMed中组合使用“环境的”、“职业的”、“暴露”、“癌症”、“一级预防”和“干预”这些搜索词,确定相关研究。为补充文献综述,于2011年3月17—18日在西班牙阿斯图里斯亚召开了“癌症的环境与职业决定因素:一级预防干预”国际会议,该会议由世界卫生组织主办。[讨论]很多由环境和职业引起的癌症都是可以预防的。一级预防政策通过减少或消除非自愿暴露于确认或潜在致癌物质,可最有效地实现预防目的。根据现有的知识,这些策略直接且经济有效,还具有附带效益,即通过减少共同风险因素的暴露,协同降低其他非传染性疾病的风险。[结论]通过整合环境和职业性致癌物初级干预来重振全球癌症控制政策是可能的。
[Background] Each year, nearly 13 million new cancer cases worldwide and 7.6 million cancer deaths occur. 63% of cancer deaths occur in low- and middle-income countries. A significant proportion of cancers are caused by environmental and workplace exposure to carcinogens. [Purpose] To develop an evidence-based global vision and strategy for the primary prevention of environmental and occupational cancers. [Method] By searching for PubMed using “Environment ” “Occupation ”, “Exposure ”, “Cancer ”, “Primary Prevention ” and “Intervention Words, to determine the relevant research. To supplement the literature review, the International Conference on ”Environmental and Occupational Determinants of Cancer: Primary Prevention of Interventions" was held in Asturias, Spain, from 17-18 March 2011, organized by the World Health Organization. [DISCUSSION] Many cancers caused by the environment and occupations are preventable. Primary prevention policies can most effectively achieve their prevention goals by reducing or eliminating involuntary exposure to confirmed or potential carcinogens. Based on current knowledge, these strategies are straightforward and cost-effective with the attendant benefits of synergistically reducing the risk of other noncommunicable diseases by reducing the exposure to common risk factors. [Conclusions] It is possible to revitalize the global cancer control policy by integrating environmental and occupational carcinogen primary interventions.