Preventability of Cancer: The Relative Contributions of Biologic and Social and Physical Environmental Determinants of Cancer Mortality
Ce rapport annuel américain fait le point sur l'ensemble des facteurs et déterminants biologiques, sociaux, physiques et environnementaux impliqués dans l'incidence des 4 cancers les plus fréquents et la mortalité des patients afin de définir des stratégies de prévention
While models of cancer disparities and variation in cancer burden within population groups now specify multiple levels of action from biologic processes to individual risk factors and social and physical contextual factors, approaches to estimating the preventable proportion of cancer use more traditional direct models often from single exposures to cancer at specific organ sites. These approaches are reviewed and the strengths and limitations presented. The need for additional multilevel data and approaches to estimation of preventability is identified. International or regional variation in cancer may offer the most integrated exposure assessment over the life-course. For the 4 leading cancers that account for 50% of incidence and mortality, biologic, social, and physical environment play differing roles in etiology and potential prevention. Better understand of the interactions and contributions across these levels will help refine prevention strategies. Expected final online publication date for the Annual Review of Public Health Volume 33 is March 17, 2012. Please see http://www.annualreviews.org/catalog/pubdates .aspx for revised estimates.
Annual Review of Public Health , résumé, 2011