Biostatisticians have developed a “calculator” of cancer risk factors

What causes of cancer are known today, what oncological diseases are more likely to affect men, women, the elderly and representatives of various professions, as well as how to minimize their risks, oncologists told Gazeta.Ru.

Biostatisticians from the Yale University School of Public Health have developed a mathematical model to calculate the proportion of various factors in the development of 24 types of cancer. Scientists told more about it in an article in the journal Molecular Biology And Evolution.

The researchers took into account both the influence of the environment and known genetic mutations, being able to assess the contribution of each known factor. It turned out that external causes play a major role in the development of melanoma and bladder cancer, but prostate cancer and glioma are largely due to internal processes associated with age.

While this approach does not provide significant new information, it does provide an opportunity to assess the risk of cancer in individual patients or groups of people, such as in workplaces or areas where abnormally high rates of cancer are observed.

The authors of the work consider:

This can be useful in terms of giving people feedback that will let them know what causes their cancer. Perhaps not everyone wants to know this. But on a personal level, it can be helpful for people to relate disease to its cause.

In addition, the model could allow doctors to assess the risks of developing certain types of cancer in patients and give them timely recommendations. This approach can be used on a larger scale, taking into account all possible risks when developing cancer prevention strategies.

Public health interventions to minimize exposure to avoidable risk factors could mitigate disease severity by preventing the accumulation of mutations that directly promote cancer, the researchers write.

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“Scientists have long tried to assess the extent to which any person’s tumor developed as a result of preventable actions (eg UV exposure, smoking, etc.) versus aging or random mutations. Previously, other groups of scientists have already shown that it is possible to reliably predict how certain factors that cause specific mutations change the genome in tissues. Combining this knowledge with their method, which quantifies the contribution of each mutation to cancer, the researchers showed a specific percentage of the blame that should be placed on known and unknown factors in the occurrence of cancer, ”the chief oncologist of SM-Clinic told Gazeta.Ru , Doctor of Medical Sciences, Professor Alexander Seryakov.

“In general, attempts to prevent the development of cancer remain relevant, and the search for new ways of prevention is necessary, however, there will probably not be special expectations and prerequisites for the development of this area in the near future. This is especially true for the most common diseases (since in these cases the risk factors have been studied in some detail). But with regard to rarer forms of cancer, this remains extremely relevant, since early diagnosis and treatment of these diseases is still difficult, ”Suna Isakova, an oncologist at the SberHealth medical online service, said in an interview with Gazeta.Ru.

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In Russia, cancer is the second most common cause of death, Seryakov points out. Almost 4 million cancer patients are registered in the country.

“The most well-studied factors that increase the risk of developing cancer are hereditary predisposition, infectious diseases that cause chronic inflammation, smoking, alcoholism, poor environment, radiation, ultraviolet radiation, reduced immunity (including as a result of chronic stress and depression) , physical inactivity, excess weight, frequent contact with carcinogens, ”says Seryakov.

Nutrition also plays a significant role.

“Every third case of cancer of the pancreas, intestines, stomach is associated with a systematic imbalance in the diet. Carcinogens include fried foods, smoked foods, an abundance of fast carbohydrates and trans fats, an abundance of protein foods of animal origin (more than ⅕ of the total volume), nitrates that accumulate in vegetables and fruits grown on an industrial scale, where nitro compounds are used to accelerate growth and development plants,” adds the doctor.

About 10% of cancer cases are related to heredity. In particular, it plays a role in the development of breast and ovarian tumors in women and prostate cancer in men, and intestinal cancer.

“For common pathologies, risk factors have been studied in some detail. Ultraviolet radiation, smoking are factors that are probably known to a large number of people. Also, external factors include infection with hepatitis B virus (especially in combination with hepatitis D), highly oncogenic strains of human papillomavirus (6.11, 16, 18, etc.). Quite rarely, infection with aflatoxin B1 occurs, in which liver cancer develops, ”Isakova notes.

Women most often experience breast cancer, the main role in the development of which is played by hereditary factors (mutations in the BRCA1, BRCA2, CHE2, NBS1 and others genes) and reproductive factors associated with prolonged exposure to estrogens on the mammary gland – early onset of menstruation, late menopause, later the birth of the first child.

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“Other factors that increase the risk of developing breast cancer include alcohol use, overweight and obesity, and physical inactivity. These factors are recognized as the main ones in 21% of all deaths from breast cancer in the world,” says Seryakov.

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Among men, lung cancer is the most common, it also remains the first in Russia and the world in terms of mortality among men and women.

In addition to smoking, which is recognized as the most common cause of lung cancer, genetic predisposition plays a role, work in hazardous industries associated with radiation, dust, inhalation of chemicals, life in megacities and near large industrial enterprises, overweight, malnutrition, alcoholism, old age and stress.

“Among professions with a high risk of oncology, metallurgists are in the lead with an indicator of 41.18% and builders, which account for 11.76% of cases,” Seryakov adds. – The most dangerous profession is an electric and gas welder. Representatives of this profession are most often diagnosed with tumors. Oncological diseases account for 0.33% of all occupational diseases. Due to harmful and difficult working conditions, bronchi and lungs (64.71%), stomach and larynx (11.76%), kidneys (5.88%) are most often affected by cancer.

Working with asbestos is also dangerous for the lungs, but a significant increase in the risk of developing lung cancer is only worth worrying about with prolonged contact – for example, workers in processing plants, mines, and processing plants.

Oddly enough, office work is associated with the risk of developing cancer. The role of a sedentary lifestyle in the development of oncological diseases, as well as work with pesticides, welding equipment, work associated with ionizing radiation, has been proven.

With age, the risks of developing cancer increase, and people aged 51-73 years are at the greatest risk.

“Each age is characterized by the development of its own type of cancer, certain organs suffer with age,” Seryakov explains. – Statistics of the significance of cancer development from age shows that in patients under 20 years of age (average age 15 years), mortality is minimal and amounts to 0.3%. According to world statistics for 2020, there are 18 million new cases among older people, and a death rate of 9.6 million patients. These data are relevant to this day. The accumulation of mutations in genes with age is one of the main reasons why cancer will probably never be completely defeated. The problem of fighting cancer is closely intertwined with the problem of population aging.”

In adulthood, more attention should be paid to the diagnosis of cancer, Isakova emphasizes. From the age of 45, it is recommended to donate feces for occult blood annually and undergo a colonoscopy every 10 years. Men over 50 years of age – take a blood test for PSA (prostate-specific antigen), women over 40-50 years old – once every 1-2 years, undergo a mammogram. From the age of 50, low-dose chest CT is recommended for smokers.

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From the age of 21, women should additionally take a PAP test (a smear from the cervix) every 3 years, and after 30 years – a PAP test with an analysis for HPV every 5 years.

In Russia, regular clinical examination has proven to be an effective tool for early detection of the most common types of cancer.

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“Compulsory clinical examination helps to diagnose cancer in the early stages almost eight times more often. The list of examinations and studies within the framework of medical examination depends on the age and gender of the citizen. So, for example, during the medical examination, women are examined by a gynecologist with a smear taken from the cervix for a cytological examination, and from the age of 39 – mammography. Conducting a full screening of cervical cancer can reduce the incidence of cervical cancer by 80% and mortality from this disease by 72%. Mammography is an effective screening method for women over 39 years of age. Over 50 years, thanks to mammography, mortality from breast cancer among women in countries where screening coverage exceeds 70% has decreased by 20-30%,” says Seryakov.

Lung cancer can be detected by fluorography or low-dose CT, which has replaced it in places.

If a particular type of cancer is suspected, additional examinations are prescribed based on the results of the medical examination. The most informative of them is a biopsy of the affected tissues.

There is no way to guarantee 100% protection against cancer – even if all possible risk factors are excluded, random mutations can play a role. However, giving up bad habits can reduce the likelihood of facing cancer.

Less obvious preventive measures include healthy sleep, notes Seryakov – for a healthy immune system and cancer prevention, you should sleep 7-8 hours every night, and working the night shift is considered a probable carcinogen. In addition, natural coffee has a protective effect – about five cups a day reduce the risk of laryngeal cancer and malignant brain tumors. Walking in the fresh air is also beneficial, as it generally reduces the risk of premature death from all causes, including cancer.

In addition, vaccination against hepatitis B and human papillomavirus, including for men, will help protect yourself, Isakova adds. Do not neglect sunscreen either.

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