Up to a third of breast cancer cases in Western countries could be avoided if women ate less and exercised more, researchers at a breast cancer conference said Thursday — comments that could ignite heated discussions among victims and advocates.
虽然更先进的治疗方法、及早诊断以及乳房X光筛查等医学手段已经显著地减缓了这种疾病，专家称对乳腺癌关注的焦点现在应当转移到改变生活方式上，比如饮食和身体运动。“医学筛查手段能够达到的目标，已经都达到了。我们没法做到更多，”意大利米兰大学（University of Milan）流行病学系主任卡洛·拉维基亚（Carlo La Vecchia）告诉美联社。“是时候从医疗手段转移到其他方法上了。”
While better treatments, early diagnosis and mammogram screenings have dramatically slowed the disease, experts said the focus should now shift to changing behaviors like diet and physical activity. "What can be achieved with screening has been achieved. We can't do much more," Carlo La Vecchia, head of epidemiology at the University of Milan, told The Associated Press. "It's time to move onto other things."
La Vecchia spoke Thursday on the influence of lifestyle factors at a European breast cancer conference in Barcelona.
Breast cancer is the most common cancer in women. In Europe, there were about 421,000 new cases and nearly 90,000 deaths in 2008, the latest available figures. The United States last year saw more than 190,000 new cases and 40,000 deaths. A woman's lifetime chance of getting breast cancer is about one in eight.
Many breast cancers are fueled by estrogen, a hormone produced in fat tissue. So experts suspect that the fatter a woman is, the more estrogen she's likely to produce, which could in turn spark breast cancer. Even in slim women, exercise can help reduce the cancer risk by converting more of the body's fat into muscle.
Any discussion of weight and breast cancer is a politically sensitive topic, for some may misconstrue that as the medical establishment blaming victims for getting breast cancer. Victims themselves could also feel guilty, wondering just how much a factor weight played in their getting the disease.
伊恩·曼利（Ian Manley），一家英国慈善团体“乳腺癌护理”（Breast Cancer Care）的代言人，说他的机构一直对提出类似的生活方式上的建议保持很谨慎的态度。“我们永远不想让女性感觉她们自己对她们的乳腺癌负有责任，”他说。“乳腺癌是一种复杂的疾病，有如此多的引发因素，而仅仅只是责备体重这一个因素是很难理解的。”
Ian Manley, a spokesman for Breast Cancer Care, a British charity, said his agency has always been very careful about issuing similar lifestyle advice. "We would never want women to feel responsible for their breast cancer," he said. "It's a complex disease and there are so many factors responsible that it's difficult to blame it on one specific issue."
拉维基亚援引了国际癌症研究机构（International Agencyfor Research on Cancer；简称IARC）的相关数据，数据估计如果女性身体更瘦，同时运动更多的话，25%到30%的乳腺癌可能能够避免。
La Vecchia cited figures from the International Agency for Research on Cancer, which estimated that 25 to 30 percent of breast cancer cases could be avoided if women were thinner and exercised more.
That means staying slim and never becoming overweight in the first place. Robert Baan, an IARC cancer expert, said it wasn't clear if women who lose weight have a lower cancer risk or if the damage was already done from when they were heavy.
Drinking less alcohol could also help. Experts estimate that having more than a couple of drinks a day can boost a woman's risk of getting breast cancer by four to 10 percent.
After studies several years ago linked hormone replacement therapy to cancer, millions of women abandoned the treatment, leading to a sharp drop in breast cancer rates. Experts said a similar reduction might be seen if women ate better — consuming less fat and more vegetables — and exercised more.
哈佛大学（Harvard University）的癌症专家米歇尔·福尔摩斯（Michelle Holmes）说，改变生活方式，比如饮食和营养结构，可以认为比控制其他引发乳腺癌的因素更为简单。 “女性早孕能够防止女性患上乳腺癌，但是少女怀孕是一种严重的社会问题，所以我们并不鼓励这种行为，”她在接受电话采访时说。“而减肥和增加身体运动则不会有这样的负面影响。”
Michelle Holmes, a cancer expert at Harvard University, said changing things like diet and nutrition is arguably easier than tackling other breast cancer risk factors. "Women who have early pregnancies are protected against breast cancer, but teenage pregnancy is a social disaster so it's not something we want to encourage," she said in a phone interview from Cambridge, Massachusetts. "But there's no downside to reducing obesity and increasing physical activity."
She also said people may mistakenly think their chances of getting cancer are more dependent on their genes than their lifestyle. "The genes have been there for thousands of years, but if cancer rates are changing in a lifetime, that doesn't have much to do with genes," she said.
In the 1980s and 1990s, breast cancer rates steadily increased, in parallel with the rise in obesity and the use of hormone replacement therapy, which involves estrogen.
La Vecchia said countries like Italy and France — where obesity rates have been stable for the past two decades — show that weight can be controlled at a population level. "It's hard to lose weight, but it's not impossible," he said. "The potential benefit of preventing cancer is worth it."
2010-04-01 19:29 编辑：kuaileyingyu
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