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Editorial: Changing of the Guard-A New Editor for Epidemiologic Reviews. 社论:守卫的改变——流行病学评论的新编辑。
IF 5.5 2区 医学 Q1 Medicine Pub Date : 2018-06-01 DOI: 10.1093/epirev/mxx017
Michel A Ibrahim
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引用次数: 0
Prevalence of Posttraumatic Stress Disorder in Prisoners. 囚犯创伤后应激障碍的患病率。
IF 5.5 2区 医学 Q1 Medicine Pub Date : 2018-06-01 DOI: 10.1093/epirev/mxx015
Gergõ Baranyi, Megan Cassidy, Seena Fazel, Stefan Priebe, Adrian P Mundt

People involved with criminal justice frequently are exposed to violence and traumatic experiences. This may lead to posttraumatic stress disorder (PTSD); however, no review, to our knowledge, has synthetized findings in this setting. We conducted a systematic review and meta-analysis to estimate prevalence rates of PTSD in prison populations. Original studies in which prevalence rates of PTSD in unselected samples of incarcerated people were reported were systematically searched between 1980 and June 2017. Data were pooled using random-effects meta-analysis, and sources of heterogeneity for prespecified characteristics were assessed by meta-regression. We identified 56 samples comprising 21,099 imprisoned men and women from 20 countries. Point prevalence of PTSD ranged from 0.1% to 27% for male, and from 12% to 38% for female prisoner populations. The random-effects pooled point prevalence was 6.2% (95% confidence interval: 3.9, 9.0) in male prisoners and 21.1% (95% confidence interval: 16.9, 25.6) in female prisoners. The heterogeneity between the included studies was very high. Higher prevalence was reported in samples of female prisoners, smaller studies (n ≤ 200), and for investigations based in high-income countries. Existing evidence shows high levels of PTSD among imprisoned people, especially women. Psychosocial interventions to prevent violence, especially against children and women, and to mitigate its consequences in marginalized communities must be improved. Trauma-informed approaches for correctional programs and scalable PTSD treatments in prisons require further consideration.

涉及刑事司法的人经常面临暴力和创伤经历。这可能导致创伤后应激障碍(PTSD);然而,据我们所知,没有一篇综述综合了这方面的研究结果。我们进行了一项系统回顾和荟萃分析,以估计监狱人群中PTSD的患病率。在1980年至2017年6月期间,系统地检索了未选择的被监禁人员样本中PTSD患病率的原始研究。使用随机效应荟萃分析汇总数据,并通过荟萃回归评估预先指定特征的异质性来源。我们确定了56个样本,包括来自20个国家的21,099名被监禁的男女。在男性囚犯中,PTSD的点患病率从0.1%到27%不等,在女性囚犯群体中,PTSD的点患病率从12%到38%不等。随机效应合并点患病率在男性囚犯中为6.2%(95%可信区间:3.9、9.0),在女性囚犯中为21.1%(95%可信区间:16.9、25.6)。纳入研究之间的异质性非常高。据报道,在女性囚犯样本、小型研究(n≤200)和基于高收入国家的调查中,患病率较高。现有证据表明,在被监禁的人中,尤其是女性,创伤后应激障碍的发病率很高。必须改进社会心理干预措施,以防止暴力,特别是针对儿童和妇女的暴力,并减轻其对边缘化社区的影响。惩教项目的创伤知情方法和监狱中可扩展的创伤后应激障碍治疗需要进一步考虑。
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引用次数: 123
HIV and Viral Hepatitis Among Imprisoned Key Populations. 监禁重点人群中的艾滋病毒和病毒性肝炎。
IF 5.5 2区 医学 Q1 Medicine Pub Date : 2018-06-01 DOI: 10.1093/epirev/mxy003
Andrea L Wirtz, Ping T Yeh, Natalie L Flath, Chris Beyrer, Kate Dolan

Prisons and other closed facilities create opportunities for transmission of human immunodeficiency virus (HIV) and viral hepatitis during detention and after release. We conducted a systematic review and meta-analysis of peer-reviewed publications (2005-2015) to describe the prevalence of HIV, hepatitis C virus, and hepatitis B virus among key populations in prisons worldwide and to compare estimates of infection with those of other prison populations. Most data were reported for people who inject drugs (PWID; n = 72) and for men who have sex with men (MSM; n = 21); few data were reported on sex workers (SW; n = 6), or transgender women (n = 2). Publications were identified from 29 countries, predominantly middle- and high-income countries. Globally, PWID had 6 times the prevalence of HIV (pooled prevalence ratio (PPR) = 6.0, 95% CI: 3.8, 9.4), 8 times the prevalence of hepatitis C virus (PPR = 8.1, 95% CI: 6.4, 10.4), and 2 times the prevalence of hepatitis B virus (PPR = 2.0, 95% CI: 1.5, 2.7) compared with noninjecting prisoner populations. Among these articles, only those from Iran, Scotland, Spain, and Italy included the availability of methadone therapy; 2 articles included information on access to needle exchange programs by PWID detainees. HIV prevalence was more than 2 times higher among SW (PPR = 2.6, 95% CI: 2.2, 3.1) and 5 times higher among MSM (PPR = 5.3, 95% CI: 3.5, 7.9) compared with other prisoners. None of these articles reported HIV prevention coverage among SW or transgender women; 1 described HIV and sexually transmitted infection screening for MSM in prison. Prevention programs specific to key populations are important, particularly for populations that are criminalized and/or may cycle in and out of prison.

监狱和其他封闭设施在拘留期间和释放后为人体免疫缺陷病毒(艾滋病毒)和病毒性肝炎的传播创造了机会。我们对同行评审的出版物(2005-2015年)进行了系统回顾和荟萃分析,以描述全球监狱关键人群中艾滋病毒、丙型肝炎病毒和乙型肝炎病毒的流行情况,并将其与其他监狱人群的感染估计数进行比较。报告的大多数数据是针对注射吸毒者(PWID;n = 72)和男男性行为者(MSM;N = 21);很少有关于性工作者的数据报告(SW;n = 6),或变性女性(n = 2)。论文来自29个国家,主要是中等收入和高收入国家。在全球范围内,与非注射囚犯人群相比,PWID的HIV患病率为6倍(合并患病率(PPR) = 6.0, 95% CI: 3.8, 9.4),丙型肝炎病毒患病率为8倍(PPR = 8.1, 95% CI: 6.4, 10.4),乙型肝炎病毒患病率为2倍(PPR = 2.0, 95% CI: 1.5, 2.7)。在这些文章中,只有来自伊朗、苏格兰、西班牙和意大利的文章包括美沙酮治疗的可用性;2篇文章包括PWID在押人员获得针头交换项目的信息。与其他囚犯相比,SW囚犯的HIV患病率高出2倍多(PPR = 2.6, 95% CI: 2.2, 3.1), MSM囚犯的HIV患病率高出5倍(PPR = 5.3, 95% CI: 3.5, 7.9)。这些文章都没有报道性侵妇女或变性妇女的艾滋病毒预防覆盖率;1描述了监狱中男男性行为者的艾滋病毒和性传播感染筛查。针对重点人群的预防方案很重要,特别是对犯罪和/或可能进出监狱的人群。
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引用次数: 38
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 Medicine 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 Medicine 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 Medicine 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 Medicine 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 Medicine 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 Medicine 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
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 Medicine 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
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