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The Art of Casting Nets: Fishing for the Prize of Personalized Cancer Prevention

机译：铸造网的艺术：钓鱼获个性化癌症预防奖

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Now, more than ever, there is great need for personalized cancer prevention. We define personalized cancer prevention as a strategy that will enable each person to reduce his or her risk for lethal cancer by matching the dose, duration, and timing of an intervention with their own cancer risk profile. Most research studies provide us with data on the average person. But who is the average person anyway? The central tenet of personalized cancer prevention is that average is overrated. In this article, we frame what are the major obstacles to developing personalized cancer-reducing interventions: the lack of validated, non-invasive stratifiers of risk; the U-shaped dose response between cancer-fighting nutrients (e.g., selenium) and DNA damage, meaning that more of a good thing is not necessarily a good thing; the relatively brief duration of interventions evaluated in human prevention trials; the challenge of finding populations in which the impact of early life interventions on the incidence of cancers affecting older adults can be studied; and the interindividual differences in gene expression that may influence a person's response to a particular nutrient. Moreover, we contend that those who study personalized cancer prevention will need a unique constellation of expertise, including an understanding of cancer and aging, a passion for prevention, and proven health communication skills. We propose that becoming cross-trained in cancer and aging and taking more responsibility for communicating health-related research to the public in the proper context are two of the most important ways scientists can move us all closer to the goal of personalized cancer prevention. Every fisherman knows that where he casts his net determines his catch. Now, we ask: When it comes to solving the cancer problem, where should we be casting our nets?
机译：现在，比以往任何时候都更加需要个性化的癌症预防。我们将个性化癌症预防定义为一种策略，该策略将使每个人都可以通过将干预的剂量，持续时间和时机与他们自己的癌症风险状况相匹配来降低其致死性癌症的风险。大多数研究为我们提供了有关普通人的数据。但是反正普通人是谁？个性化癌症预防的中心原则是平均水平被高估。在本文中，我们概述了开发个性化的减少癌症干预措施的主要障碍：缺乏经过验证的，非侵入性的危险分层；抗癌营养素（例如硒）与DNA损伤之间呈U型剂量反应，这意味着更多的好事并不一定是好事;在人类预防试验中评估的干预措施的持续时间相对较短；寻找能够研究早期干预措施对影响老年人的癌症发生率的影响的人群的挑战；基因表达的个体差异可能会影响一个人对特定营养素的反应。而且，我们认为那些研究个性化癌症预防的人将需要独特的专业知识，包括对癌症和衰老的理解，对预防的热情以及成熟的健康交流技能。我们建议，在癌症和衰老领域接受交叉训练，并在适当的背景下承担更多与公众进行健康相关研究的责任，这是科学家们可以使我们所有人更接近个性化癌症预防目标的两种最重要方法。每个渔民都知道，将鱼投到哪里决定了捕鱼量。现在，我们问：在解决癌症问题时，我们应该在哪里撒网？

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