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Rigakafin Cutar Daji

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Rigakafin Cutar Daji
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Rigakafin Cutar Daji Ya kasan ce shi ne matakin farko da ake rage haɗarin cutar sankara da mace-macen da akeyi ta sanadiyyar ta.[1][2] Rigakafin kuma ta dogara ne akan ƙoƙarin daidaita da kuma inganta salon rayuwa, da zamantakewar mutane da tattalin arziki ko manufofin jama'a masu alaƙa da rigakafin cutar kansa.[3] Ana ɗaukar rigakafin cutar kansa ta duniya a matsayin muhimmin maƙasudi saboda zartar da shi ga ɗimbin jama'a, da kuma rage tasirin kansa na dogon lokaci ta hanyar haɓaka ayyuka da ɗabi'un kiwon lafiya masu fa'ida, da fa'idar ingancin farashi da yuwuwan sa.[2]

Yawancin cututtukan daji na farawa ne daga tarin gurɓataccen muhalli wanda yana afkuwa ne ta hanyar lalacewar epigenetic , amma ba duka ba ne ake kamuwa da cutar kansan ta hanyar gurɓataccen muhalli.[4] Fiye da kashi 75 cikin 100 na mace-macen cutar daji za a iya kiyaye su ta hanyar guje wa abubuwan haɗari da suka haɗa da: taba, kiba, rashin isasshen abinci, rashin motsa jiki, barasa, da dai sauran su, cututtukan da ake ɗauka ta hanyar jima'i, da gurɓataccen iska.[5][6] Ba duk cututtukan kansar za a iya sarrafawa ba, irin abubuwan da ke faruwa ta zahiri da kuma sauran lokuta na ciwon daji ana haifar da su ta hanyar gado. Dabarun gyara kwayoyin halitta na yanzu da ke ƙarƙashin haɓakawa na iya zama matakan kariya a nan gaba.[7] Hakanan za'a iya inganta matakan rigakafin nan gaba kuma ta hanyar ingan tashi da haɓaka ƙayyadaddun abubuwa ta hanyar yin la'akari da tsarin halittar mutum ɗaya, wanda kuma aka sani da cutar kansa ta tushe."[2]

Mai da hankali

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Adadin mace-mace da aka daidaita don shekaru don cutar kansa mai cutarwa cikin 100,000 mazauna a 2004.

  no data
  ≤ 55
  55–80
  80–105
  105–130
  130–155
  155–180

  180–205
  205–230
  230–255
  255–280
  280–305
  ≥ 305

Yayin da kowa zai iya kamuwa da cutar kansa,[8] shekaru na ɗaya daga cikin manyan abubuwan da za su iya sa mutum ya fi kamuwa da cutar kansa: 3 cikin 4 na ciwon daji ana samun su ne a cikin mutane masu shekaru 55 ko fiye.

Abincin abinci

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Wannan tallan yana ba da shawarar cin abinci mai kyau don hana ciwon daji.

Duk da yake an ba da shawara akan abincin da yake rage haɗarin ciwon daji, shaidar da za ta goyi bayan hakia kuma.[9][10] Abubuwan abinci na farko waɗanda ke haɓaka karin haɗarin cutar su ne kiba da shan barasa ; tare da kuma rage yawan cin 'ya'yan itatuwa da kayan marmari da jan nama mai yawa da akeci amma ba a tabbatar ba.[11][12] Bincike na 2014 bai sami dangantaka tsakanin 'ya'yan itatuwa da kayan marmari da ciwon daji ba.[13] Yin amfani da kofi yana hade da rage hadarin ciwon hanta.[14] Nazarin ya danganta yawan amfani da jan naman da aka sarrafa yana kara haɗarin ciwon nono, ciwon hanji, da ciwon daji na pancreatic, al'amari wanda zai iya kasancewa saboda kasancewar carcinogens a cikin naman da aka dafa.[15][16] Shawarwari na abinci don rigakafin ciwon daji yawanci sun haɗa da girmamawa ga kayan lambu, 'ya'yan itace, hatsi gabaɗaya, da kifi, da kuma nisantar sarrafa jan nama (naman sa, naman alade, rago), kitsen dabba, da ingantaccen carbohydrates.[9][10]

Ayyukan jiki

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Bincike ya kuma nuna cewa motsa jiki na yau da kullun yana taimakawa wajen rage kusan kashi 30%[17][18] Na haɗarin nau'ikan ciwon daji iri-iri, kamar kansar hanji, kansar nono, kansar huhu da kansar endometrium.[19][20] Har yanzu ba a fahimci hanyoyin ilimin halittu da ke ƙarƙashin wannan ƙungiyar ba[20] amma an yi nazarin hanyoyin ilimin halitta daban-daban da ke tattare da cutar kansa wanda ke nuna cewa aikin jiki yana rage haɗarin kansa ta hanyar taimakawa sarrafa nauyi, rage hormones kamar estrogen da insulin, rage kumburi da ƙarfafa rigakafi.[20] [21]

Magunguna da kari

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Ma'anar cewa ana iya amfani da magunguna don hana ciwon daji yana da kyau, kuma shaida ta goyi bayan amfani da su a cikin wasu ƙayyadaddun yanayi. [22]  A cikin yawan jama'a, NSAIDs sun rage haɗarin ciwon daji na launi duk da haka saboda cututtukan zuciya da na gastrointestinal suna haifar da cutar gaba ɗaya lokacin amfani da rigakafi.[23] An gano Aspirin yana rage haɗarin mutuwa daga cutar kansa da kusan kashi 7%.[24] COX-2 inhibitor na iya rage adadin samuwar polyp a cikin mutanen da ke da polyposis na iyali adenomatous duk da haka suna da alaƙa da illa iri ɗaya kamar NSAIDs.[25] An nuna amfani da tamoxifen ko raloxifene a kullum don rage haɗarin kamuwa da cutar kansar nono a cikin mata.[26] Fa'idar cutarwa ga mai hana 5-alpha-reductase irin su finasteride bai bayyana ba.[27] An kuma yi wani binciken da ke nuna ƙa'idar hujja tare da sunadaran ɗan adam IFNalpha2a da macrophage-CSF, waɗanda kaji da aka gyara ta halitta suka samar. [28]

Ba a gano bitamin suna da tasiri wajen hana ciwon daji ba,[29] ko da yake ƙananan matakan bitamin D suna da alaƙa da haɗarin ciwon daji.[30][31] Ko wannan dangantakar tana da sanadi kuma ƙarin bitamin D yana da kariya ba a ƙayyade ba.[32] An gano ƙarin beta-carotene yana ƙara yawan ciwon huhu a cikin waɗanda ke da haɗari.[33] Ba a sami ƙarin folic acid mai tasiri a hana ciwon daji na hanji ba kuma yana iya ƙara polyps na hanji.[34] Wani nazari na yau da kullum na 2018 ya kammala cewa selenium ba shi da wani tasiri mai amfani wajen rage hadarin ciwon daji bisa ga shaidar inganci.[35]

Alurar riga kafi

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Maganin rigakafin ciwon daji na iya zama / rigakafi ko kuma a yi amfani da shi azaman magani na warkewa.[2] Duk irin waɗannan alluran suna haifar da rigakafi na daidaitawa ta hanyar haɓaka ƙimar cytotoxic T lymphocyte (CTL) da kuma aikin antigens masu alaƙa ko ƙari (TAA da TSAs).

An samar da alluran rigakafin da ke hana kamuwa da cuta daga wasu ƙwayoyin cuta na carcinogenic.[36] Alurar rigakafin cutar papillomavirus ( Gardasil da Cervarix ) na rage haɗarin kamuwa da cutar kansar mahaifa .[36] Alurar rigakafin ciwon hanta na B na hana kamuwa da cutar hanta ta B don haka yana rage haɗarin ciwon hanta.[36] Ana ba da shawarar gudanar da maganin papillomavirus na ɗan adam da rigakafin hanta na B lokacin da albarkatu suka ba da izini.[37]

Wasu allurar rigakafin cutar kansa yawanci tushen immunoglobulin ne kuma suna hari antigens musamman ga kansa ko ƙwayoyin ɗan adam mara kyau.[2][38] Ana iya ba da waɗannan alluran rigakafin cutar kansa don magance cutar kansa yayin ci gaban cuta don haɓaka ikon tsarin rigakafi na ganewa da kai hari kan antigens na cutar kansa a matsayin ƙasashen waje. Ana iya ɗaukar ƙwayoyin rigakafin cutar kansa daga jikin majiyyaci (alurar rigakafi ta atomatik) ko daga wani majiyyaci (allogeneic alurar riga kafi).[36] An sake fitar da wasu alluran rigakafi na autologous, irin su Oncophage don ciwon koda da Vitespen don ciwon daji iri-iri, ko dai an sake su ko kuma suna fuskantar gwaji na asibiti. Magungunan da FDA ta amince da su, irin su Sipuleucel-T don metastasizing kansar prostate ko Nivolumab don melanoma da kansar huhu na iya yin aiki ko dai ta hanyar yin niyya akan abubuwan da aka bayyana ko maye gurbi ta hanyar wuraren bincike na rigakafi ɗan lokaci don haɓaka ayyukan rigakafi.[2][39]

Hanyoyin tantancewa, waɗanda aka fi nema don ƙarin kamuwa da cutar kansa, irin su hanji, nono, da mahaifa, sun inganta sosai a cikin ƴan shekarun da suka gabata daga cigaban gano ƙwayoyin halitta da ganowa.[2] Gano farkon ciwon daji na pancreatic biomarkers an cika shi ta amfani da tsarin rigakafi na tushen SERS.[40] A SERS-base multiplex proteinbiomarker gano dandamali a cikin guntu microfluidic don ganowa ana amfani da shi don gano furotin biomarkers da yawa don tsinkayar nau'in cuta da masu mahimmancin halittu da haɓaka damar ganowa tsakanin cututtuka tare da masu siyar da halittu masu kama (PC, OVC, da pancreatitis).[41]

Ciwon mahaifa

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Yawanci ana yin gwajin kansar mahaifa ta hanyar gwajin vitro na sel da mahaifa (misali Pap smear), colposcopy, ko duba kai tsaye na cervix (bayan aikace-aikacen dilute acetic acid), ko gwajin HPV, kwayar cutar oncogenic wanda shine dalilin da ya dace na ciwon daji na mahaifa. Ana ba da shawarar dubawa ga mata masu shekaru 21, da farko mata masu shekaru 21 zuwa 29 ana ƙarfafa su ta hanyar karɓan hoton Pap a kowace shekara uku, kuma waɗanda suka wuce 29 a kowace shekara biyar. [2] Ga matan da suka girmi shekaru 65 kuma ba su da tarihin kansar mahaifa ko rashin daidaituwa, kuma tare da fifikon da ya dace na sakamakon gwajin Pap na iya dakatar da dubawa akai-akai.[42]

Duk da haka, riko da tsare-tsaren tantancewa da aka ba da shawarar da ya dogara da shekaru kuma ana iya danganta shi da "matakin ilimi, al'adu, al'amurran da suka shafi tunanin mutum, da matsayin aure," yana kara jaddada mahimmancin magance waɗannan ƙalubalen dangane da gwajin cutar kansa.[2]

Ciwon daji mai launi

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An fi duba ciwon daji mai launi tare da gwajin jini na fecal occult (FOBT). Bambance-bambancen wannan gwajin sun haɗa da FOBT na tushen guaiac (gFOBT), gwajin rigakafi na fecal (FIT), da gwajin DNA (sDNA).[43] Ƙarin gwaji ya haɗa da sassauƙan sigmoidoscopy (FS), jimlar colonoscopy (TC), ko ƙididdigar hoto (CT) idan TC bai dace ba. Shawarar shekarun da za a fara nunawa shine shekaru 50. Koyaya, wannan ya dogara sosai akan tarihin likita da fallasa abubuwan haɗari na CRC. An nuna ingantaccen tantancewa don rage haɗarin CRC da kashi 33% da ɗabi'a na CRC da kashi 43%.[2]

An kiyasta adadin sabbin cutar sankarar nono a Amurka a cikin 2018 ya zarce miliyan 1.7, tare da mutuwar sama da dubu dari shida.[44] Abubuwa kamar girman nono, rage yawan motsa jiki, kiba da matsayi mai kiba, rashin haihuwa da rashin haihuwa, maganin maye gurbin hormone (HRT), da kwayoyin halitta sune abubuwan haɗari ga ciwon nono. [2] Ana amfani da mammogram sosai don auna cutar kansar nono, kuma ana ba da shawarar ga mata masu shekaru 50-74 ta Ƙungiyar Ayyukan Kariya ta Amurka (USPSTF). Duk da haka, USPSTF ta ba da shawarar a kan mammographies ga mata masu shekaru 40-49 saboda yuwuwar kamuwa da cuta fiye da kima.[2][45]

Abubuwan da ake iya hana kamuwa da cutar daji

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Kamar yadda na 2017, amfani da taba, abinci da abinci mai gina jiki, aikin jiki, kiba / kiba matsayi, cututtuka masu yaduwa, da sinadarai da carcinogens na jiki an ruwaito su zama manyan wuraren da za a iya yin rigakafin ciwon daji ta hanyar aiwatar da canje-canjen salon rayuwa, samun dacewa na yau da kullum. tantancewa, da yin allurar rigakafi.

Ci gaban ciwon daji da yawa na kowa yana haifar da irin waɗannan abubuwan haɗari. Misali, shan taba da barasa, tarihin likitanci na warts da STDs, rigakafin rigakafi, jima'i mara kariya, da farkon lokacin jima'i da juna biyu duk na iya zama abubuwan haɗari ga kansar mahaifa. Kiba, jan nama ko cin nama da aka sarrafa, taba da barasa, da tarihin likitanci na cututtukan hanji masu kumburi duk abubuwan haɗari ne ga cutar kansar colorectal (CRC). A gefe guda, motsa jiki da cin kayan lambu na iya taimakawa rage haɗarin CRC.[2]

An bayyana wasu abubuwan da za a iya hana kamuwa da cutar sankara a cikin binciken Doll da Peto na 1981,[5] da aka kiyasta cewa kashi 75 - 80% na cututtukan daji a Amurka za a iya kiyaye su ta hanyar guje wa abubuwa 11 daban-daban. Binciken 2013 na ƙarin wallafe-wallafen rigakafin ciwon daji na kwanan nan ta Schottenfeld et al., [46] taƙaita binciken da aka ruwaito tsakanin 2000 da 2010, yana nuna yawancin abubuwan da za a iya kaucewa daga Doll da Peto. Koyaya, Schottenfeld et al. an yi la'akari da ƙananan abubuwa (misali rashin haɗa da abinci) a cikin bita fiye da Doll da Peto, kuma sun nuna cewa guje wa waɗannan ƙananan abubuwan zai haifar da rigakafin 60% na mutuwar ciwon daji. Teburin da ke ƙasa yana nuna adadin mutuwar ciwon daji wanda aka danganta da dalilai daban-daban, yana taƙaita abubuwan lura na Doll da Peto, Shottenfeld et al. da wasu marubuta da dama, kuma suna nuna tasirin manyan abubuwan rayuwa a kan rigakafin cutar kansa, kamar taba, abinci mara kyau, kiba da cututtuka.

Adadin mace-macen cutar sankara a Amurka an danganta shi da dalilai daban-daban
Factor Doll da Peto [5] Schottenfeld et al. Sauran rahotanni
Taba 30% 30% 38% maza, 23% mata, 30%, 25-30%
Abinci mara kyau 35% - 32%, 10%, 30-35% [47]
Kiba * 10% 14% mata, 20% maza, a tsakanin wadanda ba shan taba ba, 10-20%, [47] 19-20% Amurka, 16-18% Burtaniya, 13% Brazil, 11-12% China
Kamuwa da cuta † 10% 5-8% 7-10%, 8% kasashe masu ci gaba, 26% kasashe masu tasowa, [48] 10% babban kudin shiga, 25% na Afirka [47]
Barasa 3% 3-4% 3.6%, [48] 8% Amurka, 20% Faransa
Bayyanar sana'a 4% 3-5% 2-10%, na iya zama 15-20% a cikin maza
Radiation (rana da ionizing) 3% 3-4% har zuwa 10% [47]
Rashin aikin jiki * <5% 7%
Haihuwa da halayyar jima'i 1-13% - -
Gurbacewa 2% - -
Magunguna da hanyoyin likita 1% - -
Kayayyakin masana'antu <1% - -
Additives na abinci <1% - -

* Kunshe cikin abinci

Cututtukan ciwon daji sun haɗa da: ga cervix na mahaifa (human papillomavirus [HPV]), hanta (hepatitis B virus [HBV] da cutar hepatitis C [HCV]), ciki ( Helicobacter pylori [ H pylori ]), ƙwayoyin lymphoid (Epstein-Barr). cutar [EBV]), nasopharynx (EBV), mafitsara urinary ( Schistosoma hematobium ), da biliary tract ( Opisthorchis viverrini, Clonorchis sinensis ).

Tarihin rigakafin ciwon daji

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An yi tunanin ciwon daji cuta ce da za a iya rigakafinta tun lokacin likitan Romawa Galen, wanda ya lura cewa cin abinci mara kyau yana da alaƙa da kamuwa da cutar kansa. A cikin 1713, likitan Italiyanci Ramazzini ya ɗauka cewa kauracewa ya haifar da ƙananan ciwon daji na mahaifa a cikin mata. Ci gaba da lura a cikin karni na 18 ya haifar da gano cewa wasu sinadarai, irin su taba, soot da kwalta (wanda ke haifar da ciwon daji a cikin masu shara, kamar yadda Percivall Pot ya ruwaito a 1775), na iya zama cutar kansa ga mutane. Ko da yake Potts ya ba da shawarar matakan kariya don share bututun hayaki (sanya tufafi don hana hulɗar jikin mutum tare da soot), shawarwarin nasa an aiwatar da su ne kawai a cikin Holland, wanda ke haifar da raguwar ƙwayar cutar kansar ƙwayar cuta a cikin bututun hayaki. Daga baya, karni na 19 ya kawo farkon rarrabuwa na sinadarai na carcinogens.[49]

A farkon karni na 20, an gano cututtukan daji na zahiri da na halitta, irin su radiation na X ray ko Virus na Rous Sarcoma da aka gano a 1911. Duk da alaƙar yanayin muhalli ko abubuwan sinadarai tare da ci gaban kansa, an sami gazawar bincike na rigakafi na yau da kullun da canje-canjen salon rayuwa don rigakafin cutar kansa ba su yuwu a wannan lokacin.[50]

A Turai, a cikin 1987 Hukumar Tarayyar Turai ta ƙaddamar da dokar hana cutar daji ta Turai don taimakawa jama'a game da matakan da za su iya ɗauka don rage haɗarin kamuwa da cutar kansa. [51] Sigar farko ta Code ɗin ta ƙunshi shawarwari guda 10 da suka shafi taba, barasa, abinci, nauyi, bayyanar rana, fallasa ga sanannun ƙwayoyin cuta, ganowa da wuri da shiga cikin shirye-shiryen tantancewar nono da cutar kansar mahaifa. [52] A farkon 1990s, Makarantar Kankara ta Turai ta jagoranci nazarin Code kuma ya kara dalla-dalla game da shaidar kimiyya a bayan kowane shawarwarin. [52] Hukumar Bincike kan Ciwon daji ta Duniya ta haɗu da sabuntawa daga baya. Buga na huɗu na Code, [1], wanda aka haɓaka a cikin 2012-2013, ya kuma haɗa da shawarwari game da shiga cikin shirye-shiryen rigakafin rigakafin cutar hepatitis B (jarirai) da papillomavirus na ɗan adam ('yan mata), ciyar da nono da maye gurbin hormone, da shiga cikin tsarin launi mai tsari. shirye-shiryen gwajin cutar kansa.

  • Microplastics ci ta hanyar abinci
  • Haɓaka halittar ɗan adam
  • Asusun Kariya da Magani
  • Ranar Cutar daji ta Duniya

Hanyoyin haɗi na waje

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