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Cancer risk can be reduced by adopting a healthy lifestyle and by medical means. Tobacco control is central to public policies for cancer prevention. Overweight and obesity in the United States may contribute to 20% of cancer deaths in women and 14% in men. Cancer prevention strategies have progressed from a predominant lifestyle approach to a model that combines clinical investigations in a medical...
A first-degree relative of an individual with colorectal cancer is on average at about a twofold increased risk. This could not occur without there being strong underlying risk factors that are correlated in relatives. About 90% of colorectal cases occur in people who are above median familial/genetic risk, so there is great potential to use genetics to prevent colorectal cancer. Two rare inherited...
Gastric cancer has been declining for more than half a century, whereas the incidence of oesophageal cancer is increasing rapidly. The histopathological subtype is also changing with a predominance of oesophageal adenocarcinoma compared with squamous carcinoma. The reasons for these epidemiological changes are not clear, although population-based data have implicated gastro-oesophageal reflux disease...
Metabolic syndrome was initially described as an aggregation of risk factors for the development of coronary artery disease with insulin resistance and compensatory hyperinsulinemia as the underlying factor. In an earlier review, we suggested that hyperinsulinemia may also lead to prostate cancer (PCa), the most common male cancer in industrialized nations. Furthermore, we suggested that diet and...
Many cancer prevention strategies are unlikely to provide equal risk reduction in all subjects, but instead are predicted to be particularly useful for specific individuals. An important research challenge is to devise methods for individualization of cancer prevention recommendations, such that particular interventions are assigned to those who will gain the most. Research in this area is at an early...
Animal models provide unparalleled mechanistic insights into cancer development and potential opportunity for cancer prevention. Nevertheless, species differ markedly with regard to dietary exposures, cancer development, drug effects, and toxicity thresholds; therefore, testing in a single animal system may not predict human responses. Although replication of human cancer in animal models remains...
Investigations employing surrogate cancer end points are especially attractive because they may be smaller, shorter, and cheaper than comparable studies with explicit cancer outcomes. For many potential surrogate end points—epithelial cell proliferation will be taken as an example—inferences are problematic because of the existence of alternative causal pathways to cancer that bypass the surrogate...
Carcinogenesis proceeds through a very long preclinical period. Our collective hope is that multiple opportunities exist for chemoprevention to arrest or reverse progression towards malignancy. In the hope of faster progress with fewer subjects and lower total cost, much effort is being expended on the search for reliable biomarkers to predict the likelihood of developing cancer and/or to signal the...
Epidemiologic observations and preclinical experimental investigations suggest that the prevention or reversal of precancers should be an effective strategy in humans to control cancer. Although “proof of principle” has been established in humans, the results of randomized trials have not been confirmatory in most cases. Toxicity in normal or near-normal populations has also been greater than anticipated...
Between 9,000 and 18,000 new cases of breast cancer per year in the United States are associated with a genetically defined predisposition [1, 2]. Mutations in BRCA1 and 2 account for greater than 60% of inherited breast cancer. Mutations in additional undiscovered high and low penetrance genes may account for the other 40% of inherited breast cancer cases and possibly a subset of familial breast...
Lung cancer remains a major cause of mortality worldwide, despite advances in surgery, radiotherapy and chemotherapy. Most patients present with advanced disease, and early detection approaches are still experimental. Chemoprevention strategies are therefore essential. Chemoprevention can be defined as the use of specific natural or synthetic chemical agents to reverse, suppress or prevent progression...
Nicotine is the main substance responsible for dependence on tobacco-containing products, which have a heavy impact on the public health of developed as well as non-developed countries by being a main etiologic factor for the induction of cardiovascular diseases and tobacco-related cancer. A vaccine against nicotine induces antibodies against the molecule, intercepting the nicotine on its way to its...
The past two decades have provided a vast amount of literature related to the primary prevention of colorectal cancer. Large international variation in colorectal cancer incidence and mortality rates and the prominent increases in the incidence of colorectal cancer in groups that migrated from low-to high-incidence areas provided important evidence that lifestyle factors influence the development...
In the third millennium, preventive medicine is becoming a cornerstone in our concept of health. Colorectal cancer (CRC) prevention, in particular, has become an important goal for health providers, physicians and the general public. CRC fits the criteria of a disease suitable for chemopreventive interventions. It is a prevalent disease that is associated with considerable mortality and morbidity...
Considerable progress has been made in the past three decades in our understanding of the biology and prevention of colorectal cancer. The long natural history of colorectal cancer as it evolves from adenomatous polyps in the majority of cases provides opportunities for detection of early stage cancer and for prevention of cancer by removal of adenomas. Strong evidence of the effectiveness of screening...
Breast cancer is the most common cause of cancer death in women worldwide. Rates vary about fivefold around the world, but they are increasing in regions that until recently had low rates of disease. Despite the numerous uncertainties surrounding the etiology of breast cancer, intensive epidemiological, clinical, and genetic studies have identified a number of biological and social traits as risk...
There are many facets to cancer prevention: a good diet, weight control and physical activity, a healthy environment, avoidance of carcinogens such as those in tobacco smoke, and screening of populations at risk to allow early detection. But there is also the possibility of using drugs or naturally occurring compounds to prevent initiation of, or to suppress, tumour growth. Only a few such agents...
Every year approximately half a million women worldwide develop cervical cancer (CC) of whom 80% live in poor countries where population-based screening programmes are virtually non-existent. The role of sexually transmitted agents in the aetiology of cervical cancer has been suspected for more than a century, but knowledge in this field has rapidly expanded only in the last 20 years, after major...
Health economics has experienced a substantial rise within the healthcare industry over the past few years. Several disciplines have developed new techniques to evaluate the economic impact of pharmaceuticals in clinical care. Clinicians, pharmacists, economists, epidemiologists, and operations researchers have contributed to this field. Given the economic reality that resources are limited and needs...
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