癌症结局的环境决定因素:一个范围审查
Azadeh Abravan1, Isabella Fornacon-Wood1, Richard Kingston2
1Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom.
概括
像空气污染这样的环境因素会影响癌症的结果,但研究是分散的. 需要对生存率,治疗毒性和不同人群进行更多的研究,以改善癌症治疗.
科学领域:
- 环境健康 环境健康
- 在瘤学瘤学.
- 公共卫生 公共卫生
背景情况:
- 个性化癌症护理模式越来越多地考虑影响患者结果的非生物因素.
- 环境暴露被认为是癌症发病率和诊断后结果的可改变因素.
- 现有的证据将环境因素与癌症结局联系起来是零碎的,需要全面地图.
研究的目的:
- 进行范围审查,对环境因素和癌症结果的现有文献进行映射.
- 确定环境暴露与癌症死亡率,治疗毒性和生活质量之间的关联.
- 突出研究差距,数据挑战和转化研究和政策的机会.
主要方法:
- 使用范围审查方法来系统地搜索和综合相关文献.
- 包括检查各种环境因素与癌症结果之间的关系的研究.
- 分析了文献,以确定常见的暴露,结果指标和研究的地理分布.
主要成果:
- 空气污染和是研究最多的环境因素,与较差的肺癌结果有着一致的联系.
- 其他因素,如工业场所的近距离,化学污染物,绿地,噪音和气象等因素的研究较少.
- 大多数研究集中在死亡率上,对治疗毒性和生活质量数据有限,研究集中在高收入国家.
结论:
- 目前关于环境因素和癌症结果的证据有限,特别是关于生存率和与治疗有关的问题.
- 在建立因果推理方面存在重大数据挑战,特别是在与诊断和治疗相关的暴露时间方面.
- 需要进行跨学科,以公平为重点的研究,以加强因果关系,并为癌症治疗中的环境暴露提供公共卫生策略的信息.
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