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Epidemiology of breast cancer, a paradigm of the “common soil” hypothesis
Seminars in Cancer Biology ( IF 14.5 ) Pub Date : 2020-02-20 , DOI: 10.1016/j.semcancer.2020.02.010
Licia Iacoviello 1 , Marialaura Bonaccio 2 , Giovanni de Gaetano 2 , Maria Benedetta Donati 2
Affiliation  

Breast cancer is the leading cause of death in women aged 20–50 years, with some geographical difference. The yearly incidence of the disease is increasing while the related mortality is steadily decreasing. Breast cancer is associated not only with specific hormones or factors related with reproduction, but mostly to more general environmental factors, linked to socioeconomic conditions and lifestyles (smoking, stress, physical exercise and particularly dietary habits). The latter, indeed, are risk factors or conditions common to hormone-dependent tumors and other chronic degenerative disorders, such as ischemic cardio cerebro-vascular and neuro-degenerative disease. Breast cancer can indeed be considered as a paradigm of the so-called “common soil” concept, according to which the above mentioned conditions, although having different clinical manifestations, share some pathogenetic mechanisms and risk factors and intermediate predisposing phenotypes (see Type2 diabetes, metabolic syndrome or obesity).

In an epidemiological perspective, evidence has been accumulated on the common response of breast cancer and cardiovascular disorders to healthy lifestyles and in particular to the beneficial effects of a close adhesion to the Mediterranean dietary model. The latter would mainly be effective thanks to its anti-inflammatory properties, thus controlling the subclinical condition of low-grade inflammation, a common risk factor of all the “common soil” disorders. Results from the prospective cohort of the Moli-sani Study (nearly 25,000 adults from the general population of the Southern Italy region of Molise) are highly suggestive in this context.

In a public health perspective, the “common soil” hypothesis may thus promote the application of preventive strategies, particularly targeting lifestyles, for a broad spectrum of widely prevalent disorders, ranging from breast cancer to myocardial infarction or cognitive impairment conditions.



中文翻译:

乳腺癌流行病学,“共同土壤”假说的范式

乳腺癌是 20-50 岁女性死亡的主要原因,但存在一定的地域差异。该疾病的年发病率正在增加,而相关死亡率却在稳步下降。乳腺癌不仅与特定的激素或与生殖有关的因素有关,而且主要与更普遍的环境因素有关,与社会经济条件和生活方式(吸烟、压力、体育锻炼,特别是饮食习惯)有关。事实上,后者是激素依赖性肿瘤和其他慢性退行性疾病(例如缺血性心脑血管和神经退行性疾病)常见的危险因素或病症。乳腺癌确实可以被认为是所谓“共同土壤”概念的范式,根据该概念,上述条件,

从流行病学的角度来看,已经积累了关于乳腺癌和心血管疾病对健康生活方式的共同反应的证据,特别是密切遵守地中海饮食模式的有益影响。后者主要是有效的,这要归功于它的抗炎特性,从而控制低度炎症的亚临床状况,这是所有“常见土壤”疾病的共同风险因素。Moli-sani 研究的前瞻性队列(来自意大利南部莫利塞地区普通人群的近 25,000 名成年人)的结果在这种情况下具有高度暗示性。

从公共卫生的角度来看,“共同土壤”假说可能会促进预防策略的应用,特别是针对生活方式的广泛流行疾病,从乳腺癌到心肌梗塞或认知障碍。

更新日期:2020-02-20
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