Cancer Prevention

Obstacles, Challenges and the Road Ahead

Frank L. Meyskens, Hasan Mukhtar, Cheryl L. Rock, Jack Cuzick, Thomas W. Kensler, Chung S. Yang, Scott D. Ramsey, Scott M. Lippman, David S Alberts

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Approaches to reduce the global burden of cancer include two major strategies: screening and early detection and active preventive intervention. The latter is the topic of this Commentary and spans a broad range of activities. The genetic heterogeneity and complexity of advanced cancers strongly support the rationale for early interruption of the carcinogenic process and an enhanced focus on prevention as a priority strategy to reduce the burden of cancer; however, the focus of cancer prevention management should be on individuals at high risk and on primary localized disease in which screening and detection should also play a vital role. The timing and dose of (chemo-)preventive intervention also affects response. The intervention may be ineffective if the target population is very high risk or already presenting with preneoplastic lesions with cellular changes that cannot be reversed. The field needs to move beyond general concepts of carcinogenesis to targeted organ site prevention approaches in patients at high risk, as is currently being done for breast and colorectal cancers. Establishing the benefit of new cancer preventive interventions will take years and possibly decades, depending on the outcome being evaluated. We also propose that comparative effectiveness research designs and the value of information obtained from large-scale prevention studies are necessary in order for preventive interventions to become a routine part of cancer management.

Original languageEnglish (US)
JournalJournal of the National Cancer Institute
Volume108
Issue number2
DOIs
StatePublished - Feb 1 2016

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Neoplasms
Comparative Effectiveness Research
Genetic Heterogeneity
Health Services Needs and Demand
Colorectal Neoplasms
Carcinogenesis
Research Design
Breast Neoplasms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Meyskens, F. L., Mukhtar, H., Rock, C. L., Cuzick, J., Kensler, T. W., Yang, C. S., ... Alberts, D. S. (2016). Cancer Prevention: Obstacles, Challenges and the Road Ahead. Journal of the National Cancer Institute, 108(2). https://doi.org/10.1093/jnci/djv309

Cancer Prevention : Obstacles, Challenges and the Road Ahead. / Meyskens, Frank L.; Mukhtar, Hasan; Rock, Cheryl L.; Cuzick, Jack; Kensler, Thomas W.; Yang, Chung S.; Ramsey, Scott D.; Lippman, Scott M.; Alberts, David S.

In: Journal of the National Cancer Institute, Vol. 108, No. 2, 01.02.2016.

Research output: Contribution to journalArticle

Meyskens, FL, Mukhtar, H, Rock, CL, Cuzick, J, Kensler, TW, Yang, CS, Ramsey, SD, Lippman, SM & Alberts, DS 2016, 'Cancer Prevention: Obstacles, Challenges and the Road Ahead', Journal of the National Cancer Institute, vol. 108, no. 2. https://doi.org/10.1093/jnci/djv309
Meyskens FL, Mukhtar H, Rock CL, Cuzick J, Kensler TW, Yang CS et al. Cancer Prevention: Obstacles, Challenges and the Road Ahead. Journal of the National Cancer Institute. 2016 Feb 1;108(2). https://doi.org/10.1093/jnci/djv309
Meyskens, Frank L. ; Mukhtar, Hasan ; Rock, Cheryl L. ; Cuzick, Jack ; Kensler, Thomas W. ; Yang, Chung S. ; Ramsey, Scott D. ; Lippman, Scott M. ; Alberts, David S. / Cancer Prevention : Obstacles, Challenges and the Road Ahead. In: Journal of the National Cancer Institute. 2016 ; Vol. 108, No. 2.
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