Early Life Exposures and Adult Cancer Risk.

IF 5.2 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Epidemiologic Reviews Pub Date : 2017-01-01 DOI:10.1093/epirev/mxx004
Megan A Clarke, Corinne E Joshu
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引用次数: 59

Abstract

Very little is known about the influence of early life exposures on adult cancer risk. The purpose of this narrative review was to summarize the epidemiologic evidence relating early life tobacco use, obesity, diet, and physical activity to adult cancer risk; describe relevant theoretical frameworks and methodological strategies for studying early life exposures; and discuss policies and research initiatives focused on early life. Our findings suggest that in utero exposures may indirectly influence cancer risk by modifying biological pathways associated with carcinogenesis; however, more research is needed to firmly establish these associations. Initiation of exposures during childhood and adolescence may impact cancer risk by increasing duration and lifetime exposure to carcinogens and/or by acting during critical developmental periods. To expand the evidence base, we encourage the use of life course frameworks, causal inference methods such as Mendelian randomization, and statistical approaches such as group-based trajectory modeling in future studies. Further, we emphasize the need for objective exposure biomarkers and valid surrogate endpoints to reduce misclassification. With the exception of tobacco use, there is insufficient evidence to support the development of new cancer prevention policies; however, we highlight existing policies that may reduce the burden of these modifiable risk factors in early life.

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早期生活暴露与成年癌症风险。
人们对早期生活暴露对成年癌症风险的影响知之甚少。这篇叙述性综述的目的是总结与早期吸烟、肥胖、饮食和体育活动与成年癌症风险相关的流行病学证据;描述研究早期生活暴露的相关理论框架和方法策略;并讨论有关早期生活的政策和研究计划。我们的研究结果表明,子宫内暴露可能通过改变与致癌相关的生物学途径间接影响癌症风险;然而,需要更多的研究来确定这些关联。在儿童和青少年时期开始接触致癌物可能会通过增加致癌物暴露的持续时间和终生时间和/或在关键发育时期采取行动来影响癌症风险。为了扩大证据基础,我们鼓励在未来的研究中使用生命历程框架、因果推理方法(如孟德尔随机化)和统计方法(如基于群体的轨迹建模)。此外,我们强调需要客观的暴露生物标志物和有效的替代终点来减少错误分类。除烟草使用外,没有足够的证据支持制定新的癌症预防政策;然而,我们强调现有的政策可能会减轻这些早期生活中可改变的风险因素的负担。
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来源期刊
Epidemiologic Reviews
Epidemiologic Reviews 医学-公共卫生、环境卫生与职业卫生
CiteScore
8.10
自引率
0.00%
发文量
10
期刊介绍: Epidemiologic Reviews is a leading review journal in public health. Published once a year, issues collect review articles on a particular subject. Recent issues have focused on The Obesity Epidemic, Epidemiologic Research on Health Disparities, and Epidemiologic Approaches to Global Health.
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