Introduction to Cancer Prevention

Abstract

The goals of cancer prevention are to reduce the incidence, morbidity, and mortality due to cancer through the identification and elimination of precancerous lesions (termed intraepithelial neoplasias or IENs) and/or the early detection of minimally invasive cancers. Between 2001 and 2009, the USA saw an average 1.6 % annual reduction in the total number of cancer deaths (Howlader et al., 2012). While declining death rates have been seen for all racial and ethnic groups in the USA, there have been smaller reductions among women than men and smaller reductions in deaths among African Americans as compared to populations with a European heritage (Jemal et al., 2010). These reductions were primarily due to advances in and improved access to cancer detection and prevention efforts, resulting in less exposure to risk factors such as tobacco (Jemal et al., 2010). As a result, an estimated 767,100 cancer deaths have been averted over the past two decades in the USA (Jemal et al., 2010). These averted deaths are largely driven by reductions in lung cancer (reduction in tobacco use), stomach cancer (reduced H. pylori infections and improved food storage and preservation methods), breast cancer and colorectal cancer (due to improved screening and treatment modalities), cervical cancer (Pap testing and the HPV vaccine), as well as lymphoma, leukemia, and testicular cancer (due to new treatments). Unfortunately, other cancers have increased, such as liver cancer (increasing hepatitis C infections), esophageal cancer (associated with increasing obesity and gastric reflux disease), pancreatic cancer, and melanoma (due to sun exposure). Despite the recent reduction in incidence and mortality rates, cancer remains the second leading cause of mortality in the USA (responsible for over 580,000 deaths per year) (Siegel et al., 2013). For Americans from the age of 40–79, cancer is the leading cause of death (Siegel et al., 2013). Only at age 80 and older does heart disease surpass cancer. Therefore, it is extremely important that we continue to prioritize efforts in cancer prevention and control to reduce the impact of these diseases.