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УДК: 616‑006‑058.4/5 (571.63):313.13 DOI:10.33920/med-08-2209-09

Роль социально-экономических и стрессогенных факторов риска в распространенности злокачественных новообразований (обзор литературы)

Абдуразакова Хадижат Нурмагомедовна ассистент кафедры общей гигиены и экологии человека, ФГБОУ ВО «Дагестанский государственный медицинский университет» Минздрава России, 367000, Российская Федерация, Республика Дагестан, г. Махачкала, пл. Ленина, д. 1, e-mail: Axadijat@mail.ru, https://orcid.org/0000-0003-2560-0320
Магомедов Магомед Гитиномагомедович доктор медицинских наук, профессор, заведующий кафедрой общей гигиены и экологии человека, ФГБОУ ВО «Дагестанский государственный медицинский университет» Минздрава России, 367000, Российская Федерация Республика Дагестан, г. Махачкала, пл. Ленина, д. 1, https://orcid.org/0000-0003-1897-6784, e-mail: magomedov_1957@mail.ru
Омарова Сабина Омаровна ассистент кафедры общей гигиены и экологии человека, ФГБОУ ВО «Дагестанский государственный медицинский университет» Минздрава России, 367000, Российская Федерация, Республика Дагестан, г. Махачкала, пл. Ленина, д. 1, https://orcid.org/0000-0002-2363-6461, e-mail: sabinak@mail.ru
Гасанова Зульмира Магомедовна ассистент кафедры общей гигиены и экологии человека, ФГБОУ ВО «Дагестанский государственный медицинский университет» Минздрава России, 367000, Российская Федерация, Республика Дагестан, г. Махачкала, пл. Ленина, д. 1, https://orcid.org/0000-0002-2195-0174, e-mail: gsm75@yandex.ru

Злокачественные новообразования (ЗНО) — значимая общественная, социальная и медицинская проблема современного общества. Рак — ведущая причина смертности в мире, от которой в 2020 г. умерло порядка 10 млн человек. В связи с этим выявление основных факторов, способствующих онкогенезу, является наиболее актуальной задачей современной клинической медицины. Опухолевые образования злокачественного генеза полиэтиологичны. Окончательно не установлено, какой из факторов имеет первостепенное значение, однако выявлено, что триггерами являются различные психосоциальные процессы. Среди них: социальное положение, условия работы, жизненные события (депрессия, безнадежность, потеря близкого человека и т. д.). Детальное изучение связи психосоциальных факторов и факторов внешней среды в развитии, прогрессировании и смертности от определенных видов ЗНО имеет важное значение в понимании основных механизмов профилактики данной патологии. Анализ полученных результатов может быть учтен в разработке персонифицированных мероприятий по предупреждению развития ЗНО у конкретного индивида.

Литература:

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1. Golivets TP, Kovalenko BS. Analysis of world and russian trends in cancer incidence in the twenty-first century. Research Result. Medicine and Pharmacy Series. 2015; 1 (4): 125–131. (In Russian) doi: 10.18413 / 2313‑8955‑2015‑1‑4‑125‑131.

2. Lung, Breast and Colorectal Cancer Incidence by Socioeconomic Status in Spain: A Population-Based Multilevel Study Daniel Redondo-Sánchez, Rafael Marcos-Gragera, Marià Carulla, Arantza Lopez de Munain, Consol Sabater Gregori, Rosario Jimenez Chillarón, Marcela Guevara, Olivier Nuñez, Pablo Fernández-Navarro, María-José Sánchez, Miguel Angel Luque-Fernandez Cancers (Basel) 2021 Jun; 13 (11): 2820. Published online 2021 Jun 5. doi: 10.3390/cancers13112820.

3. Bian Liu, Katherine A. Ornstein, Naomi Alpert, Rebecca M. Schwartz, Kavita V. Dharmarajan, Amy S. Kelley, Emanuela Taioli, Trends of hospitalizations among patients with both cancer and dementia diagnoses in New York 2007–2017, Healthcare, 10.1016/j. hjdsi.2021.100565, 9, 3, (100565), (2021).

4. Ellis L, Canchola A, Spiegel D, Ladabaum U, Haile R, Gomez S. Racial and ethnic disparities in cancer survival: the contribution of tumor, sociodemographic, institutional, and neighborhood characteristics. J Clin Oncol. 2018; 36: 25–33.

5. Teng AM, Atkinson J, Disney G, Wilson N, Blakely T. Changing socioeconomic inequalities in cancer incidence and mortality: cohort study with 54 million person-years follow-up 1981–2011. Int J Cancer. 2017; 140: 1306–1316.

6. Nabaa HA, Shelleh N. Barriers preventing Palestinian women from having a mammogram: a qualitative study. Lancet. 2018; 391: S16.

7. Li R, Daniel R, Rachet B. How much do tumor stage and treatment explain socioeconomic inequalities in breast cancer survival? Applying causal mediation analysis to population-based data. Eur J Epidemiol. 2016; 31: 603–611.

8. Kumachev A, Trudeau ME, Chan KK. Associations among socioeconomic status, patterns of care and outcomes in breast cancer patients in a universal health care system: Ontario’s experience. Cancer. 2016; 122: 893–898.

9. Hagedoorn P, Vandenheede H, Vanthomme K, Gadeyne S. Socioeconomic position, population density and site-specific cancer mortality: a multilevel analysis of Belgian adults, 2001–2011. Int J Cancer. 2018; 142: 23–35.

10. Quaglia A, Lillini R, Mamo C, Ivaldi E, Vercelli M. Socio-economic inequalities: a review of methodological issues and the relationships with cancer survival. Crit Rev Oncol Hematol. 2013; 85: 266–77. doi: 10.1016/j.critrevonc.2012.08.007.

11. Woods LM, Rachet B, Coleman MP. Choice of geographic unit influences socioeconomic inequalities in breast cancer survival. Br J Cancer. 2005; 92: 1279–82. doi: 10.1038/sj.bjc.6602506.

12. Hendrika J Luijendijk, How to create PICO questions about diagnostic tests, BMJ Evidence-Based Medicine, 10.1136/ bmjebm-2021–111676, (bmjebm-2021-111676), (2021).

13. Clement-Duchene C, Stock S, Xu X, Chang ET, Gomez SL, West DW, et al. Survival among never-smokers with lung cancer in the cancer care outcomes research and surveillance study. Ann Am Thorac Soc. 2016; 13: 58–66. doi: 10.1513/AnnalsATS.201504241OC.

14. Dalton SO, Steding-Jesen M, Jakobsen E, Mellemgaard A, Osterlind K, Schuz J, et al. Socioeconomic position and survival after lung cancer: influence of stage, treatment and comorbidity among Danish patients with lung cancer diagnosed in 2004–2010. Acta Oncol. 2015; 54: 797–804. doi: 10.3109/0284186X.2014.1001037.

15. Chouaid C, Debieuvre D, Durand-Zaleski I, Fernandes J, Scherpereel A, Westeel V, et al. Survival inequalities in patients with lung cancer in France: a nationwide cohort study (the TERRITOIRE Study). PLos ONE. 2017; 12: e0182798. doi: 10.1371/journal. pone.0182798.

16. Akinyemiju TF, Genkinger JM, Farhat M, Wilson A, Gary-Webb TL, Tehranifar P. Residential environment and breast cancer incidence and mortality: a systematic review and meta-analysis. BMC Cancer. 2015; 15: 191. doi: 10.1186/s12885‑015‑1098‑z.

17. Lundqvist A, Andersson E, Ahlberg I, Nilbert M, Gerdtham U. Socioeconomic inequalities in breast cancer incidence and mortality in Europe-a systematic review and meta-analysis. Eur J Public Health. 2016; 26: 804–13. doi: 10.1093/eurpub/ckw070.

18. Aizer AA, Chen M-H, McCarthy EP, et al. Marital status and survival in patients with cancer. J Clin Oncol. 2013; 31: 3869–3876.

19. Kissane DW. Marriage is as protective as chemotherapy in cancer care. J Clin Oncol. 2013; 31: 3852–3853.

20. Wang K, Li X, Zhou C, et al. Socio-economic factors influencing tumor presentation and treatment options in Chinese breast cancer patients. Asian Pac J Cancer Prev. 2013; 14: 267–74.

21. Yang Liu, Jian Zhang, Rong Huang, Wei-Liang Feng, Ya-Nan Kong, Feng Xu, Lin Zhao, Qing-Kun Song, Jing Li, Bao-Ning Zhang, Jin-Hu Fan, You-Lin Qiao, Xiao-Ming Xie, Shan Zheng, Jian-Jun He, Ke Wang Influence of occupation and education level on breast cancer stage at diagnosis, and treatment options in China: A nationwide, multicenter 10‑year epidemiological study Medicine (Baltimore) 2017 Apr; 96 (15): e6641. Published online 2017 Apr 14. doi: 10.1097/MD.0000000000006641.

22. Ginsburg O, Bray F, Coleman MP, et al. The global burden of women’s cancers: a grand challenge in global health. The Lancet. 2017; 389: 847–860.

23. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018; 68: 394–424.

24. American Cancer Society. Cancer Facts & Figures 2018. American Cancer Society; 2018.

25. Loomis D, Guha N, Hall AL, Straif K. Identifying occupational carcinogens: an update from the IARC Monographs. Occup Environ Med. 2018; 75: 593–603.

26. Hamra GB, Guha N, Cohen A, et al. Outdoor particulate matter exposure and lung cancer: a systematic review and meta-analysis. Environ Health Perspect. 2014; 122: 906–911.

27. Lewandowska AM, Rudzki M, Rudzki S, Lewandowski T, Laskowska B. Environmental risk factors for cancer — review paper. Ann Agric Environ Med. 2019 Mar 22; 26 (1): 1–7. doi: 10.26444/aaem/94299.

28. Nutrition in patients with cancer: a new area for medical oncologists? A practising oncologist’s interdisciplinary position paper Stefan Rauh, Andrea Antonuzzo, Paolo Bossi, Robert Eckert, Marie Fallon, Anna Fröbe, Silvia Gonella, Raffaele Giusti, Gabor Lakatos, Daniele Santini, Anna Villarini ESMO Open. 2018; 3 (4): e000345. Published online 2018 May 5. doi: 10.1136/ esmoopen-2018–000345.

29. Tobacco smoking after diagnosis of cancer: clinical aspects Jacek Jassem Transl Lung Cancer Res. 2019 May; 8 (Suppl 1): S50 — S58. doi: 10.21037/tlcr.2019.04.01.

30. Umamaheswaran S, Dasari SK, Yang P, Lutgendorf SK, Sood AK. Stress, inflammation, and eicosanoids: an emerging perspective. Cancer Metastasis Rev. 2018; 37 (2–3): 203–211.

31. Chida Y, Hamer M, Wardle J, Steptoe A. Do stress-related psychosocial factors contribute to cancer incidence and survival? Nat Clin Pract Oncol. 2008; 5 (8): 466–75.

32. Flores IE, Sierra-Fonseca JA, Davalos O, Saenz LA, Castellanos MM, Zavala JK, Gosselink KL. Stress alters the expression of cancerrelated genes in the prostate. BMC Cancer. 2017; 17 (1): 621.

33. Mols F., Husson O., Roukema J.A., & van de Poll-Franse L.V. Depressive symptoms are a risk factor for all-cause mortality: results from a prospective population-based study among 3,080 cancer survivors from the PROFILES registry. Journal of Cancer Survivorship. 2013; 7 (3): 484–492. doi: 10.1007/s11764‑013‑0286‑6.

34. Lin J., Blalock, J. A., Chen M., Ye Y., Gu J., Cohen L. … Wu X. Depressive symptoms and short telomere length are associated with increased mortality in bladder cancer patients. Cancer Epidemiology Biomarkers & Prevention. 2015; 24 (2): 336–343. doi: 10.1158/1055–9965. EPI-14–0992.

35. Fidler MM, Gupta S, Soerjomataram I, Ferlay J, Steliarova-Foucher E, Bray F. Cancer incidence and mortality among young adults aged 20–39 years worldwide in 2012: a population-based study. Lancet Oncol. 2017; 18: 1579–89. doi: 10.1016/S1470–2045 (17) 30677–0.

36. Chang A, Le CP, Walker AK, Creed SJ, Pon CK, Albold S, et al. β2‑Adrenoceptors on tumor cells play a critical role in stress-enhanced metastasis in a mouse model of breast cancer. Brain Behav Immun. 2016; 57: 106–15. doi: 10.1016/j.bbi.2016.06.011.

37. Androulidaki A, Dermitzaki E, Venihaki M, Karagianni E, Rassouli O, Andreakou E, et al. Corticotropin releasing factor promotes breast cancer cell motility and invasiveness. Mol Cancer. 2009; 8: 30. doi: 10.1186/1476‑4598‑8‑30.

38. Zhi X, Li B, Li Z, Zhang J, Yu J, Zhang L, et al. Adrenergic modulation of AMPKdependent autophagy by chronic stress enhances cell proliferation and survival in gastric cancer. Int J Oncol. 2019; 54: 1625–38. doi: 10.3892/ijo.2019.4753.

39. Zhang X, Zhang Y, He Z, Yin K, Li B, Zhang L, et al. Chronic stress promotes gastric cancer progression and metastasis: an essential role for ADRB2. Cell Death Dis. 2019; 10: 788. doi: 10.1038/s41419‑019‑2030‑2.

40. Chen H, Liu D, Guo L, Cheng X, Guo N, Shi M. Chronic psychological stress promotes lung metastatic colonization of circulating breast cancer cells by decorating a pre-metastatic niche through activating beta-adrenergic signaling. J Pathol. 2018; 244: 49–60. doi: 10.1002/path.4988.

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Злокачественные новообразования (ЗНО) являются наиболее значимой глобальной проблемой современной клинической медицины. Данные Международного агентства по изучению рака свидетельствуют о ежегодной регистрации порядка 12 млн новых случаев рака и около 6,2 млн летальных исходов от него. Прогноз ЗНО в мире является неутешительным и свидетельствует о росте данной патологии к 2050 г. до 24 млн случаев [1].

Ведущая роль в развитии данной патологии отводится социальным детерминантам, которые, по мнению ВОЗ, определены как «обстоятельства, в которых люди рождаются, растут, живут, работают и стареют, формирующиеся вследствие распределения денежных средств, ресурсов власти на глобальном, национальном и местном уровнях» [2].

Социальные факторы включают жилищные условия, образовательные и экономические факторы, транспортные системы, социальные связи и другие факторы, отражающие взаимосвязанные социальные структуры и экономические системы, сформированные распределением имеющихся ресурсов [3].

Многими учеными изучался относительный вклад социально-экономических обстоятельств в развитие онкопатологии на разных этапах жизненного пути человека: в детстве (воздействие вирусных инфекций, материальные, бытовые, жилищные условия, социальное окружение ребенка), во взрослой жизни (образ жизни, наличие вредных факторов риска, род деятельности, условия быта и др.) [4–9].

Возможность объяснения наличия связи между развитием онкопатологии и определенными социально-экономическими факторами является достаточно актуальной вследствие определения мероприятий, способствующих преодолению их пагубного воздействия на организм человека.

Цель — провести анализ данных литературных источников, посвященных вопросам роли социально-экономических факторов в развитии онкопатологии.

Для поиска литературных источников использованы ресурсы https://www.ncbi.nlm.nih.gov/pubmed и https://elibrary.ru/, процитировано 5 отечественных и 50 зарубежных источников.

Социально-экономический статус может быть определен персонифицированно для каждого пациента (например, с помощью анкеты) или для той территориальной среды, в которой он проживает (с использованием экологического подхода, подразумевающего присвоение определенного уровня жилой зоне исследуемого) [10].

Для Цитирования:
Абдуразакова Хадижат Нурмагомедовна, Магомедов Магомед Гитиномагомедович, Омарова Сабина Омаровна, Гасанова Зульмира Магомедовна, Роль социально-экономических и стрессогенных факторов риска в распространенности злокачественных новообразований (обзор литературы). Санитарный врач. 2022;9.
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