Oncoepidemiology

The first important observations that laid the foundation for research in the field of cancer epidemiology were made in the 18th century. Back in 1713, Bernardino Ramadzini , professor of medicine at the University of Padua , drew attention to the fact that nuns are virtually absent from cervical cancer , and the incidence rate of breast cancer , on the contrary, is high; This observation gave a start to the study of the effect of sexually transmitted infections and hormonal changes (in this case connected with the vow of celibacy ) on the risk of cancer. An English naturalist, John Hill , published the book “Cautions Against the Immoderate Use of Snuff” in 1761, linking tobacco smoking to an increased risk of cancer. In 1775, a surgeon at St. Bartholomew’s London hospital, Percivell Pott , described scrotal cancer as a professional cancer of chimney sweeps (they used boys in the then England who usually walked through the pipes naked; their skin was constantly in contact with soot, which was retained in the folds of the scrotum skin ^[7] ) and thus marked the beginning of the study of occupational carcinogenic effects ^[8] .

In 1915, American statistician in his book The Mortality from Cancer Throughout the World presented data on cancer mortality statistics in various countries of the world. In 1954, the results of the first cohort studies in onco-epidemiology were published in the UK; later, such studies were widely developed ^[9] .

Professor A.V. Chaklin , who developed the methodological foundations of the study of the epidemiology of malignant tumors and was the chairman of the problem commission on the epidemiology of malignant tumors of the Scientific Council on Cancer of the Academy of Medical Sciences of the USSR, initiated the development of oncology and epidemiology in the USSR . For his contribution to the development of cancer epidemiology in 1982, he was awarded the USSR State Prize in the field of science ^[10] .

In modern cancer epidemiology, the following types of epidemiological studies have become widespread ^{[11] [12]} :

• environmental studies based on the analysis of medical statistics data for the subsequent determination of the links between exposure to environmental factors and public health;
• cross-sectional (one-step) studies conducted to assess the health status of groups of the population under the conditions of exposure to adverse environmental factors using the questionnaire method (for studying rare diseases, however, it is not applicable)
• case-control studies that involve comparing a group of people with a disease under study with a control group of people who do not have the disease, and studying the difference in the proportion of people exposed to the potentially harmful factor under study;
• cohort studies involving long-term observation of a group of healthy individuals exposed to some kind of exposure in order to detect cases of the disease in it;
• experimental epidemiological studies used to study differences in the prevalence of diseases before and after changing exposure conditions.

In accordance with these areas of research, in the framework of oncoepidemiology, descriptive, analytical, and experimental oncoepidemiology are distinguished ^[11] .

Oncological and epidemiological studies have identified several groups of risk factors for the occurrence of malignant tumors ^[13] :

• chemical carcinogens that enter the body through food, through the skin and mucous membranes, as well as through the lungs (by inhalation of polluted air and by smoking);
• ionizing radiation (capable of causing almost all forms of malignant tumors) and ultraviolet radiation (various forms of skin cancer );
• oncogenic viruses , some bacteria and helminths (for example, the prevalence of urogenital schistosomiasis in Africa and the Middle East contributes to the spread of squamous cell bladder cancer ^[14] ).

Malnutrition also plays a significant role in the etiology of malignant tumors (at least one third of cancer cases are associated with it), since it can significantly reduce the body's ability to resist carcinogenesis . A similar role is played by hormonal imbalance caused by both internal and external causes. Finally, an unfavorable heredity is also a significant risk factor (in some cases, it increases the risk of cancer by 100 times or more) ^[15] .

• Doll R. Cancer prevention based on epidemiology. - M .: Medicine , 1979. - 88 p.
• Zaridze D. G. Epidemiology and etiology of malignant neoplasms // Carcinogenesis / Ed. D.G. Zaridze . - M .: Medicine , 2004. - 576 p. - ISBN 5-225-04787-4 . - pp. 29-85.
• Chaklin A. Century. Edge features of the spread of malignant tumors. - L .: Medgiz , 1963. - 184 p.
• Cherenkov VG Clinical Oncology. 3rd ed. - M .: Medical book, 2010. - 434 p. - ISBN 978-5-91894-002-0 .
• Dos Santos Silva I. Cancer Epidemiology: Principles and Methods . - Lyon: IARC , 1999. - 442 p. - ISBN 92-832-0405-0 .

• The History of Cancer. History of Cancer Epidemiology . // Website of the American Cancer Society (June 12, 2014). The appeal date is March 31, 2017.

• Russian translation: The history of cancer. Iii. The history of epidemiology, screening and early detection of cancer / Per. from English ND Firsova (2016) (Neopr.) . // UNIMED website. The appeal date is March 31, 2017.