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Dynamic Models of Infectious Disease Transmission in Prisons and the General Population. 监狱和一般人群传染病传播的动态模型。
IF 5.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2018-06-01 DOI: 10.1093/epirev/mxx014
Martial L Ndeffo-Mbah, Vivian S Vigliotti, Laura A Skrip, Kate Dolan, Alison P Galvani

Incarcerated populations experience elevated burdens of infectious diseases, which are exacerbated by limited access to prevention measures. Dynamic models are used to assess the spread and control of diseases within correctional facilities and repercussions on the general population. Our systematic review of dynamic models of infectious diseases within correctional settings identified 34 studies published between 1996 and 2017. Of these, 23 focused on disease dynamics and intervention in prison without accounting for subsequent spread to the community. The main diseases modeled in these studies were human immunodeficiency virus (HIV; n = 14, 41%), tuberculosis (TB; n = 10, 29%), and hepatitis C virus (HCV; n = 7, 21%). Models were fitted to epidemiologic data in 14 studies; uncertainty and sensitivity analyses were conducted in 8, and validation of model projection against empirical data was done in 1 study. According to the models, prison-based screening and treatment may be highly effective strategies for reducing the burden of HIV, TB, HCV, and other sexually transmissible infections among prisoners and the general community. Decreasing incarceration rates were projected to reduce HIV and HCV infections among people who inject drugs and TB infections among all prisoners. Limitations of the modeling studies and opportunities for using dynamic models to develop quantitative evidence for informing prison infection control measures are discussed.

被监禁人口的传染病负担加重,而获得预防措施的机会有限又加剧了这种负担。动态模型用于评估教养所内疾病的传播和控制以及对一般人群的影响。我们对惩教机构内传染病动态模型的系统综述确定了1996年至2017年间发表的34项研究。其中,23项重点关注监狱中的疾病动态和干预,而没有考虑到随后向社区的传播。这些研究模拟的主要疾病是人类免疫缺陷病毒(HIV);n = 14, 41%),结核病(TB;n = 10, 29%)和丙型肝炎病毒(HCV;N = 7, 21%)。模型拟合了14项研究的流行病学资料;其中8项研究进行了不确定性和敏感性分析,1项研究对模型预测进行了实证数据验证。根据这些模型,基于监狱的筛查和治疗可能是减少囚犯和一般社区中艾滋病毒、结核病、丙型肝炎病毒和其他性传播感染负担的非常有效的策略。预计降低监禁率将减少注射吸毒者中的艾滋病毒和丙型肝炎病毒感染以及所有囚犯中的结核病感染。讨论了建模研究的局限性和利用动态模型开发定量证据为监狱感染控制措施提供信息的机会。
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引用次数: 54
RE: "THE HEALTH OF AMERICA'S AGING PRISON POPULATION". 回复:“美国监狱人口老龄化的健康问题”。
IF 5.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2018-01-01 DOI: 10.1093/epirev/mxy008
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引用次数: 0
Periodontal Disease, Tooth Loss, and Cancer Risk. 牙周病、牙齿脱落和癌症风险。
IF 5.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2017-01-01 DOI: 10.1093/epirev/mxx006
Dominique S Michaud, Zhuxuan Fu, Jian Shi, Mei Chung

Periodontal disease, which includes gingivitis and periodontitis, is highly prevalent in adults and disease severity increases with age. The relationship between periodontal disease and oral cancer has been examined for several decades, but there is increasing interest in the link between periodontal disease and overall cancer risk, with systemic inflammation serving as the main focus for biological plausibility. Numerous case-control studies have addressed the role of oral health in head and neck cancer, and several cohort studies have examined associations with other types of cancers over the past decade. For this review, we included studies that were identified from either 11 published reviews on this topic or an updated literature search on PubMed (between 2011 and July 2016). A total of 50 studies from 46 publications were included in this review. Meta-analyses were conducted on cohort and case-control studies separately when at least 4 studies could be included to determine summary estimates of the risk of cancer in relation to 1) periodontal disease or 2) tooth number (a surrogate marker of periodontal disease) with adjustment for smoking. Existing data provide support for a positive association between periodontal disease and risk of oral, lung, and pancreatic cancers; however, additional prospective studies are needed to better inform on the strength of these associations and to determine whether other cancers are associated with periodontal disease. Future studies should include sufficiently large sample sizes, improved measurements for periodontal disease, and thorough adjustment for smoking and other risk factors.

牙周病,包括牙龈炎和牙周炎,在成年人中非常普遍,疾病的严重程度随着年龄的增长而增加。牙周病和口腔癌之间的关系已经被研究了几十年,但人们对牙周病和整体癌症风险之间的联系越来越感兴趣,全身性炎症是生物学合理性的主要焦点。在过去的十年里,大量的病例对照研究已经研究了口腔健康在头颈癌中的作用,一些队列研究也研究了口腔健康与其他类型癌症的关系。在本综述中,我们纳入了从11篇关于该主题的已发表评论或PubMed上更新的文献检索(2011年至2016年7月)中确定的研究。本综述共纳入了来自46篇出版物的50项研究。当至少有4项研究可以纳入时,分别对队列研究和病例对照研究进行荟萃分析,以确定癌症风险与1)牙周病或2)牙齿数量(牙周病的替代标志物)相关的总结估计,并调整吸烟。现有数据支持牙周病与口腔癌、肺癌和胰腺癌风险呈正相关;然而,需要更多的前瞻性研究来更好地了解这些关联的强度,并确定其他癌症是否与牙周病有关。未来的研究应包括足够大的样本量,改进牙周病的测量方法,并彻底调整吸烟和其他危险因素。
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引用次数: 270
Reducing Cancer Burden in the Population: An Overview of Epidemiologic Evidence to Support Policies, Systems, and Environmental Changes. 减轻人口癌症负担:支持政策、制度和环境变化的流行病学证据综述。
IF 5.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2017-01-01 DOI: 10.1093/epirev/mxx009
Elizabeth A Platz

"Reducing Cancer Burden in the Population: Epidemiologic Evidence to Support Policies, Systems, and Environmental Changes" is a compilation of 11 reviews addressing aspects of primary prevention of cancer (early life factors, vitamin D, and periodontal disease and the oral microbiome); primary and secondary prevention (in the transgender population); surveillance following secondary prevention (personalizing follow-up of patients diagnosed with an adenoma based on colorectal cancer risk); tertiary prevention (physical activity as an adjuvant to cancer treatment, measurement of patient-reported physical functioning in cancer treatment trials, and implementation of palliative care recommendations); and all 3 (changing epidemiology of oral cancers). Authors discuss policies, systems, and environment (PSE) changes that may be supported by epidemiologic evidence, for example, how existing public health and clinical policies and guidelines targeting noncancer outcomes may indirectly reduce cancer burden and how some cancer control policies could be refined to enhance effectiveness. Authors also discuss where systems and environment changes are necessary to ensure routine implementation of up-to-date, evidence-based policies and guidelines. Two other articles discuss infrastructure to support identification of existing and emerging cancer problems that could be reduced or avoided, including by PSE changes. These frameworks may guide impactful cancer research relevant to cancer centers' catchment areas, as well as cancer control efforts in countries where noncommunicable diseases including cancer are on the rise. The weight of the evidence of these reviews supports opportunities for PSE changes and infrastructure that could reduce the cancer burden in populations.

“减轻人口癌症负担:支持政策、系统和环境变化的流行病学证据”汇编了11篇综述,涉及癌症一级预防的各个方面(早期生活因素、维生素D、牙周病和口腔微生物组);一级和二级预防(跨性别人群);二级预防后的监测(根据结直肠癌风险对诊断为腺瘤的患者进行个体化随访);三级预防(体育活动作为癌症治疗的辅助手段,在癌症治疗试验中测量患者报告的身体功能,以及实施姑息治疗建议);以及所有三个(口腔癌流行病学的变化)。作者讨论了可能得到流行病学证据支持的政策、系统和环境(PSE)变化,例如,针对非癌症结果的现有公共卫生和临床政策和指南如何间接减轻癌症负担,以及如何改进一些癌症控制政策以提高有效性。作者还讨论了在哪些方面需要改变制度和环境,以确保定期实施最新的、以证据为基础的政策和指南。另外两篇文章讨论了支持识别现有和新出现的癌症问题的基础设施,这些问题可以通过PSE更改来减少或避免。这些框架可以指导与癌症中心集水区相关的有影响力的癌症研究,以及在包括癌症在内的非传染性疾病呈上升趋势的国家开展癌症控制工作。这些审查的证据的重要性支持PSE变化和基础设施的机会,这些变化和基础设施可以减少人群的癌症负担。
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引用次数: 13
The Population Burden of Cancer: Research Driven by the Catchment Area of a Cancer Center. 癌症人口负担:由癌症中心集水区驱动的研究。
IF 5.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2017-01-01 DOI: 10.1093/epirev/mxx001
Caroline G Tai, Robert A Hiatt

Cancer centers, particularly those supported by the National Cancer Institute, are charged with reducing the cancer burden in their catchment area. However, methods to define both the catchment area and the cancer burden are diverse and range in complexity often based on data availability, staff resources, or confusion about what is required. This article presents a review of the current literature identifying 4 studies that have defined various aspects of the cancer burden in a defined geographical area and highlights examples of how some cancer centers and other health institutions have defined their catchment area and characterized the cancer burden within it. We then present a detailed case study of an approach applied by the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center to define its catchment area and its population cancer burden. We cite examples of how the Cancer Center research portfolio addresses the defined cancer burden. Our case study outlines a systematic approach to using publicly available data, such as cancer registry data, that are accessible by all cancer centers. By identifying gaps and formulating future research directions based on the needs of the population within the catchment area, epidemiologic studies and other types of cancer research can be directed to the population served. This review can help guide cancer centers in developing an approach to defining their own catchment area as mandated and applying research findings to this defined population.

癌症中心,特别是那些由国家癌症研究所支持的癌症中心,有责任减少其集水区的癌症负担。然而,定义集水区和癌症负担的方法是多种多样的,其复杂性往往取决于数据的可用性、工作人员的资源或对所需内容的困惑。本文对现有文献进行了回顾,确定了4项研究,这些研究确定了特定地理区域内癌症负担的各个方面,并重点介绍了一些癌症中心和其他卫生机构如何确定其集水区并确定其癌症负担特征的例子。然后,我们对加州大学旧金山分校海伦·迪勒家庭综合癌症中心应用的方法进行了详细的案例研究,以确定其集水区和人口癌症负担。我们列举了癌症中心研究组合如何解决确定的癌症负担的例子。我们的案例研究概述了一种系统的方法来使用公开可用的数据,例如所有癌症中心都可以访问的癌症登记数据。通过根据集水区内人口的需要确定差距和制定未来的研究方向,流行病学研究和其他类型的癌症研究可以针对所服务的人口。这篇综述可以帮助指导癌症中心制定一种方法来确定他们自己指定的集水区,并将研究结果应用于确定的人群。
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引用次数: 21
The Impact of Exercise on Cancer Mortality, Recurrence, and Treatment-Related Adverse Effects. 运动对癌症死亡率、复发和治疗相关不良反应的影响。
IF 5.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2017-01-01 DOI: 10.1093/epirev/mxx007
Prue Cormie, Eva M Zopf, Xiaochen Zhang, Kathryn H Schmitz

The combination of an increasing number of new cancer cases and improving survival rates has led to a large and rapidly growing population with unique health-care requirements. Exercise has been proposed as a strategy to help address the issues faced by cancer patients. Supported by a growing body of research, major health organizations commonly identify the importance of incorporating exercise in cancer care and advise patients to be physically active. This systematic review comprehensively summarizes the available epidemiologic and randomized controlled trial evidence investigating the role of exercise in the management of cancer. Literature searches focused on determining the potential impact of exercise on 1) cancer mortality and recurrence and 2) adverse effects of cancer and its treatment. A total of 100 studies were reviewed involving thousands of individual patients whose exercise behavior was assessed following the diagnosis of any type of cancer. Compared with patients who performed no/less exercise, patients who exercised following a diagnosis of cancer were observed to have a lower relative risk of cancer mortality and recurrence and experienced fewer/less severe adverse effects. The findings of this review support the view that exercise is an important adjunct therapy in the management of cancer. Implications on cancer care policy and practice are discussed.

新的癌症病例数量不断增加,存活率不断提高,导致人口迅速增长,对保健有独特的需求。运动已经被提议作为一种策略来帮助解决癌症患者所面临的问题。在越来越多的研究的支持下,主要的健康组织普遍认识到将运动纳入癌症治疗的重要性,并建议患者进行体育锻炼。本系统综述全面总结了现有的流行病学和随机对照试验证据,调查了运动在癌症管理中的作用。文献检索集中在确定运动对以下方面的潜在影响:1)癌症死亡率和复发率;2)癌症及其治疗的不良影响。总共回顾了100项研究,涉及数千名患者,他们的运动行为在诊断出任何类型的癌症后被评估。与不运动或少运动的患者相比,诊断出癌症后进行运动的患者癌症死亡率和复发的相对风险较低,不良反应较少/较轻。这篇综述的发现支持了运动是癌症治疗中一种重要的辅助疗法的观点。讨论了对癌症护理政策和实践的影响。
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引用次数: 431
A Global Cancer Surveillance Framework Within Noncommunicable Disease Surveillance: Making the Case for Population-Based Cancer Registries. 非传染性疾病监测中的全球癌症监测框架:以人群为基础的癌症登记。
IF 5.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2017-01-01 DOI: 10.1093/epirev/mxx003
Marion Piñeros, Ariana Znaor, Les Mery, Freddie Bray

The growing burden of cancer among several major noncommunicable diseases (NCDs) requires national implementation of tailored public health surveillance. For many emerging economies where emphasis has traditionally been placed on the surveillance of communicable diseases, it is critical to understand the specificities of NCD surveillance and, within it, of cancer surveillance. We propose a general framework for cancer surveillance that permits monitoring the core components of cancer control. We examine communalities in approaches to the surveillance of other major NCDs as well as communicable diseases, illustrating key differences in the function, coverage, and reporting in each system. Although risk factor surveys and vital statistics registration are the foundation of surveillance of NCDs, population-based cancer registries play a unique fundamental role specific to cancer surveillance, providing indicators of population-based incidence and survival. With an onus now placed on governments to collect these data as part of the monitoring of NCD targets, the integration of cancer registries into existing and future NCD surveillance strategies is a vital requirement in all countries worldwide. The Global Initiative for Cancer Registry Development, endorsed by the World Health Organization, provides a means to enhance cancer surveillance capacity in low- and middle-income countries.

在几种主要非传染性疾病中,癌症的负担日益加重,要求国家实施有针对性的公共卫生监测。对于传统上强调传染病监测的许多新兴经济体来说,了解非传染性疾病监测的特殊性以及其中的癌症监测的特殊性至关重要。我们提出了一个癌症监测的总体框架,允许监测癌症控制的核心组成部分。我们考察了社区对其他主要非传染性疾病和传染病的监测方法,说明了每个系统在功能、覆盖范围和报告方面的主要差异。虽然危险因素调查和生命统计登记是非传染性疾病监测的基础,但基于人群的癌症登记对癌症监测具有独特的基础作用,提供了基于人群的发病率和生存率指标。由于各国政府现在有责任收集这些数据,作为监测非传染性疾病目标的一部分,因此将癌症登记纳入现有和未来的非传染性疾病监测战略是全世界所有国家的一项重要要求。世界卫生组织认可的全球癌症登记发展倡议提供了一种手段,以加强中低收入国家的癌症监测能力。
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引用次数: 72
Patient-Reported Physical Function Measures in Cancer Clinical Trials. 癌症临床试验中患者报告的身体功能测量方法。
IF 5.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2017-01-01 DOI: 10.1093/epirev/mxx008
Thomas M Atkinson, Angela M Stover, Daniel F Storfer, Rebecca M Saracino, Thomas A D'Agostino, Denise Pergolizzi, Konstantina Matsoukas, Yuelin Li, Ethan Basch

Patient-reported outcomes (PROs) are increasingly used to monitor treatment-related symptoms and physical function decrements in cancer clinical trials. As more patients enter survivorship, it is important to capture PRO physical function throughout trials to help restore pretreatment levels of function. We completed a systematic review of PRO physical function measures used in cancer clinical trials and evaluated their psychometric properties on the basis of guidelines from the US Food and Drug Administration. Five databases were searched through October 2015: PubMed/MEDLINE, EMBASE, CINAHL (Cumulative Index of Nursing and Allied Health Literature), Health and Psychosocial Instruments, and Cochrane. From an initial total of 10,233 articles, we identified 108 trials that captured PRO physical function. Within these trials, approximately 67% used the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and 25% used the Medical Outcomes Study Short Form 36. Both the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and Medical Outcomes Study Short Form 36 instruments generically satisfy most Food and Drug Administration requirements, although neither sought direct patient input as part of item development. The newer Patient-Reported Outcomes Measurement Information System physical function short form may be a brief, viable alternative. Clinicians should carefully consider the psychometric properties of these measures when incorporating PRO instrumentation into clinical trial design to provide a more comprehensive understanding of patient function.

在癌症临床试验中,越来越多地使用患者报告结果(PROs)来监测与治疗相关的症状和身体功能下降情况。随着越来越多的患者进入存活期,在整个试验过程中捕捉患者报告的身体功能以帮助恢复治疗前的功能水平非常重要。我们对癌症临床试验中使用的PRO身体功能测量方法进行了系统性回顾,并根据美国食品药品管理局的指南对其心理测量特性进行了评估。截至 2015 年 10 月,我们检索了五个数据库:PubMed/MEDLINE、EMBASE、CINAHL(护理和联合健康文献累积索引)、健康和社会心理工具以及 Cochrane。在最初总共 10,233 篇文章中,我们确定了 108 项采集 PRO 身体功能的试验。在这些试验中,约 67% 使用了欧洲癌症研究与治疗组织的生活质量问卷,25% 使用了医学结果研究简表 36。欧洲癌症研究与治疗组织的生活质量调查表和医学结果研究简表 36 都能满足食品与药物管理局的大部分要求,但在项目开发过程中都没有直接征求患者的意见。较新的患者报告结果测量信息系统(Patient-Reported Outcomes Measurement Information System)身体功能简表可能是一种简短可行的替代方法。临床医生在将患者报告结果测量工具纳入临床试验设计时,应仔细考虑这些测量工具的心理测量特性,以便更全面地了解患者的功能。
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引用次数: 0
Cancer in Transgender People: Evidence and Methodological Considerations. 变性人的癌症:证据和方法论考虑。
IF 5.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2017-01-01 DOI: 10.1093/epirev/mxw003
Hayley Braun, Rebecca Nash, Vin Tangpricha, Janice Brockman, Kevin Ward, Michael Goodman

Transgender people comprise a diverse group of individuals whose gender identity or expression differs from that originally assigned to them at birth. Some, but not all, transgender people elect to undergo medical gender affirmation, which may include therapy with cross-sex hormones and/or surgical change of the genitalia and other sex characteristics. As cross-sex hormones administered for the purposes of gender affirmation may be delivered at high doses and over a period of decades, the carcinogenicity of hormonal therapy in transgender people is an area of considerable concern. In addition, concerns about cancer risk in transgender patients have been linked to sexually transmitted infections, increased exposure to well-known risk factors such as smoking and alcohol use, and the lack of adequate access to screening. Several publications have identified cancer as an important priority in transgender health research and called for large-scale studies. The goals of this article are to summarize the evidence on factors that may differentially affect cancer risk in transgender people, assess the relevant cancer surveillance and epidemiologic data available to date, and offer an overview of possible methodological considerations for future studies investigating cancer incidence and mortality in this population.

变性人是一个多样化的群体,他们的性别认同或性别表达方式与出生时最初被赋予的性别不 同。一些变性人(但并非所有变性人)选择接受医学性别确认,这可能包括使用异性荷尔蒙治疗和/或改变生殖器和其他性特征的手术。由于以确认性别为目的的跨性别荷尔蒙可能会在数十年内以高剂量施用,因此变性人接受荷尔蒙治疗的致癌性是一个相当令人担忧的领域。此外,对变性人患癌风险的担忧还与性传播感染、吸烟和酗酒等众所周知的风险因素的增加以及缺乏适当的筛查机会有关。一些出版物已将癌症确定为变性人健康研究的一个重要优先事项,并呼吁进行大规模研究。本文旨在总结可能对变性人患癌风险产生不同影响的因素的证据,评估迄今为止可用的相关癌症监测和流行病学数据,并概述未来调查该人群癌症发病率和死亡率的研究可能需要考虑的方法。
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引用次数: 0
Early Life Exposures and Adult Cancer Risk. 早期生活暴露与成年癌症风险。
IF 5.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2017-01-01 DOI: 10.1093/epirev/mxx004
Megan A Clarke, Corinne E Joshu

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.

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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引用次数: 59
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