Healthcare

Biostatistics has developed a “calculator” of risk factors for cancer

What causes the development of cancer are known today, what cancers most often affect men, women, the elderly and members of various professions, as well as how to minimize their risks, told Gazeta.Ru oncologists.

Biostatistics from Yale University’s School of Public Health has developed a mathematical model to calculate the proportion of various factors in the development of 24 cancers. Scientists told more about it in an article in the journal Molecular Biology And Evolution.

The researchers took into account both environmental influences and known genetic mutations, being able to assess the contribution of each known factor. External causes have been shown to play a major role in the development of melanoma and bladder cancer, but prostate cancer and glioma are largely due to internal age-related processes.

Although this approach does not provide significantly new information, it does assess the risk of cancer in individual patients or groups of people, such as in the workplace or in areas with abnormally high levels of cancer.

The authors believe:

This can be helpful in providing people with feedback that will help them find out what causes their cancer. Not everyone may want to know. But on a personal level, it can be helpful for people to relate the disease to its cause.

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

Public health measures aimed at minimizing the impact of preventable risk factors could mitigate the severity of the disease by preventing the accumulation of mutations that directly contribute to cancer, the researchers write.

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“Scientists have long tried to assess the extent to which a person’s tumor has developed as a result of preventable actions (such as exposure to ultraviolet light, smoking, etc.) compared to aging or random mutations. Previously, other groups of scientists have 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 guilt that should be attributed to known and unknown factors in the occurrence of cancer, “- told Gazeta.Ru chief oncologist” SM Clinic ” , MD, Professor Alexander Seryakov.

“In general, attempts to prevent the development of cancer remain relevant, and the search for new ways of prevention is necessary, but special expectations and prerequisites for the development of this area are unlikely in the near future. This is especially true of the most common diseases (as in these cases, risk factors have been studied in some detail). But with regard to rarer forms of cancer, this remains extremely important, as early diagnosis and treatment of these diseases are still difficult, “said Suna Isakova, an oncologist at the SberZdorovye medical online service, in an interview with Gazeta.Ru.

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

“The most well-studied factors that increase the risk of cancer are hereditary predisposition, infectious diseases that cause chronic inflammation, smoking, alcoholism, poor ecology, radiation, ultraviolet radiation, low immunity (including as a result of chronic stress). , hypodynamia, excess weight, frequent contact with carcinogens “, – says Seryakov.

Nutrition also makes a significant contribution.

“Every third case of cancer of the pancreas, intestines, stomach is associated with a systematic imbalance of diet. Carcinogens include fried foods, smoked foods, abundance of fast carbohydrates and trans fats, abundance of protein foods of animal origin (more than ⅕ of total), nitrates, which accumulate in vegetables and fruits grown on an industrial scale, where nitro compounds are used for accelerated 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, bowel cancer.

“For common pathologies, risk factors have been studied in some detail. Ultraviolet radiation, smoking – factors known probably to a large number of people. External factors also include infection with hepatitis B virus (especially in combination with hepatitis D), highly oncogenic strains of human papilloma virus (6,11, 16, 18, etc.). Infection with aflatoxin B1, which develops liver cancer, is quite rare, ”says Isakova.

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

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“Other factors that increase the risk of breast cancer include alcohol consumption, overweight and obesity, as well as physical inertia. These factors are recognized as the main in 21% of all deaths from breast cancer in the world, “said Seryakov.

Lung cancer is the most common among men, and it 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, the role is played by genetic predisposition, work in harmful industries related to radiation, dust, chemical inhalation, life in cities and near large industrial enterprises, overweight, malnutrition, alcoholism, and stress.

“Among the professions with a high risk of oncology, metallurgists are in the lead with a rate of 41.18% and builders, who account for 11.76% of cases,” adds Seryakov. – The most dangerous profession is electric gas welder. Tumors are most often diagnosed in this profession. Cancer accounts for 0.33% of all occupational diseases. Due to harmful and difficult working conditions, bronchial and lung cancers (64.71%), stomach and larynx (11.76%), kidneys (5.88%) are most often affected ”.

It is also dangerous for the lungs to work with asbestos, but a significant increase in the risk of lung cancer should be concerned only with prolonged contact – for example, workers in concentrators, mines, processing plants.

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

With age, the risk of developing cancer increases, with people aged 51-73 being at greatest risk.

“Each age is characterized by the development of its own type of cancer, with age certain organs suffer,” explains Seryakov. – Statistics on the importance of cancer from age show that patients under 20 years of age (mean age 15 years) have a minimum mortality rate of 0.3%. According to world statistics for 2020, among the elderly new cases – 18 million people, mortality – 9.6 million patients. These data are still relevant today. Accumulation of mutations in genes with age is one of the main reasons why you will probably never be able to defeat cancer once and for all. The problem of combating cancer is closely intertwined with the problem of population aging. “

In adulthood, it is worth paying more attention 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 after 50 years – to take a blood test for PSA (prostate-specific antigen), women after 40-50 years – once every 1-2 years to undergo mammography. From the age of 50, low-dose chest CT is recommended for smokers.

In addition, women should take a PAP test (cervical smear) every 3 years from the age of 21, and after 30 years – a PAP test with HPV analysis every 5 years.

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

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“Compulsory medical examination helps to diagnose cancer in the early stages almost eight times more often. The list of examinations and tests within the medical examination depends on the age and sex of the citizen. For example, during the medical examination, women are examined by a gynecologist with a smear from the cervix for cytological examination and from the age of 39 – mammography. Carrying out 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. In 50 years, mammography has reduced breast cancer mortality among women in countries with more than 70% screening, by 20-30%, ”said Seryakov.

Lung cancer can be detected by fluorography or in some places replaced by low-dose CT.

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

There is no guaranteed 100% protection against cancer – even if all possible risk factors are ruled out, random mutations can play a role. However, giving up bad habits reduces the likelihood of experiencing cancer.

Less obvious preventive measures include healthy sleep, says Seryakov – for the health of the immune system and cancer prevention should sleep every night for 7-8 hours, and work in the night shift is considered a possible carcinogen. In addition, natural coffee has a protective effect – about five cups a day reduce the risk of laryngeal cancer and malignant brain tumors. Outdoor walks are also helpful – they generally reduce the risk of premature death from all causes, including cancer.

In addition, vaccination against hepatitis B and human papilloma virus, including for men, will help protect themselves, Isakov added. Sunscreens should also not be neglected.

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