The use of biomarkers is increasing both in acute and chronic disease epidemiology, but the rationale for their introduction is not always firmly established (e.g., when and how their use is scientifically justifiable and cost effective).
The use of biomarkers should be considered within the context of causal models in epidemiology, and of the intertwining of causation and pathogenesis.
Unlike infectious diseases, for cancer and cardiovascular disease external « necessary » causes have not been identified.
Thus, the classification of cancer and other chronic diseases cannot be based on unequivocal criteria such as the « etiologic » classification of infectious diseases.
As far as morphology is concerned, « neoplasia » and « anaplasia » are attributes of cancer that cannot be defined in a straightforward way.
Tissue pathologies are minimal and difficult to differentiate from normal tissue in some cancers but are obvious in others.
From a mechanistic point of view, unless molecular biology discovers specific mechanistic steps in carcinogenesis, which indicate the existence of « necessary » events in carcinogenesis, we cannot adopt an unequivocal definition of cancer.
The potential contribution of biomarkers to the elucidation of the pathogenetic process should be considered in the light of such uncertainties. (...)
Mots-clés Pascal : Carcinogenèse, Marqueur biologique, Pathogénie, Etiologie, Epidémiologie, Homme, Article synthèse
Mots-clés Pascal anglais : Carcinogenesis, Biological marker, Pathogenesis, Etiology, Epidemiology, Human, Review
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0466026
Code Inist : 002B04E01. Création : 03/02/1998.