癌症发生强度的年龄动态表明存在一些脆弱亚群

Q3 Medicine
V.F. Obesnyuk
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引用次数: 0

摘要

管理癌症发病率或死亡率的人口和职业风险的问题以了解其形成的生物学机制为前提。这些机制决定了统计学记录的大量过程的动力学。然而,对于癌症发病率的可能因素及其真实动态之间的因果关系,人们仍然没有明确的认识。本文分析了一个关于中间过渡状态和客观存在的“脆弱”状态对“健康”和“疾病”状态之间的发病率动态产生重大影响的假设,这种状态的特征是与种群个体属性的一般变异性相关的强度相比,从观察中加速退出。据统计,胃癌、肺癌、乳腺癌、前列腺癌、甲状腺癌等常见病的发病机制可以用以下事实来解释:几乎所有确诊病例都是在一个人进入弱势群体之后,在确诊之前很久才被观察到的。从这个角度来看,应该区分两种根本不同的肿瘤发生的生物学机制:诱导是从“健康”状态到“虚弱”状态的过渡,以及促进是从“虚弱”到“疾病”的过渡。每一种转变都应根据其强度及其对内源性或外源性危险因素的依赖程度来确定其在人群中的特征。结果表明,通过对电离辐射影响下修改甲状腺癌发病率动态的例子进行数值模拟,可以在脆弱亚群的概念内满意地解释辐射敏感性指标的矛盾变化的一些已知事实。这些事实是在1994-2006年确定的,由于研究作者所讨论的概念尚未涉及,因此尚未得到适当的解释。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Age dynamics of cancer incidence intensity indicates existence of some frailty subgroups
The problem of managing population and occupational risks of cancer incidence or mortality presupposes knowledge on biological mechanisms of their formation. These mechanisms determine dynamics of mass processes recorded by statistics. However, there is still no clear understanding of the causal relationship between possible factors of cancer incidence and its real dynamics. The article analyzes a hypothesis about significant influence on dynamics of incidence rates between ‘health’ and ‘disease’ states exerted by an intermediate transitional and objectively existing ‘frailty’ state, which is characterized by accelerated withdrawal from observation compared with the intensity associated with the general variability of individual properties of a population. It has been statistically established that the dynamics of such common diseases as stomach cancer, lung cancer, breast cancer, prostate cancer, and thyroid cancer can be explained by the fact that almost all diagnosed cases are observed after an individual enters a vulnerable group long before the diagnosis itself. From this point of view, two fundamentally different biological mechanisms of occurrence of neoplasms should be distinguished: induction as a transition from the state of ‘health’ to the state of ‘frailty’, as well as promotion as a transition from ‘frailty’ to ‘disease’. Each of these transformations should be characterized in a population by their intensity and their dependence on endogenous or exogenous risk factors. It is shown that some known facts of paradoxical changes in radiosensitivity indicators can be satisfactorily interpreted within the concept of a frailty subgroup by using numerical modelling on the example of modifying the dynamics of thyroid cancer incidence under influence of ionizing radiation. The facts were established in 1994–2006 and have not yet received a proper explanation since the concept discussed by the authors of the studies has not been involved.
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来源期刊
Health Risk Analysis
Health Risk Analysis Medicine-Health Policy
CiteScore
1.30
自引率
0.00%
发文量
38
审稿时长
20 weeks
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