Using the landmark 1981 epidemiologic study by Doll and Peto of the causes cancer as their starting point, Colditz et al. review the subsequent studies of cancer incidence and report their results in Nature Reviews Cancer. Notably, Doll and Peto concluded that 75–80% of cancers diagnosed in the US in 1970 theoretically could have been avoided; they based this figure on comparisons of high- and low-incidence regions in the US with the incidence rates of other countries. This was an important finding because previously, limited data existed that related environmental factors to cancer risk; the emphasis instead had been placed on involuntary exposure to carcinogens in the workplace.
The authors note that subsequent studies added other lifestyle factors, such as obesity and lack of physical activity, to those identified by Doll and Peto as cancer risk factors. This review of the epidemiological analysis of cancer includes a number of tables that describe some of the basic features of epidemiology and epidemiologic studies. They also note that a challenge faced by epidemiologists is that the observational methods they use cannot verify results with the same certitude as laboratory experiments or randomized, controlled clinical trials. The authors go on to describe the various epidemiologic studies that have verified tobacco, radiation, viruses and other infections, and hormones as risk factors and describe how observational epidemiological methods are particularly well suited for examining the correlation between genetic factors and cancer risk or response to therapy. They also note the role of epidemiology in developing prevention strategies for those with a susceptibility to cancer and in screening and identifying biomarkers that can lead to earlier diagnosis. The authors conclude with a discussion of potential future applications of epidemiological research to study of cancer risk and prevention.
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