Introduction to Cancer Prevention

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 2002 and 2004, the United States (US) saw a 2.1% annual reduction in the total number of cancer deaths (Epsey et al. 2007). This reduction was primarily due to advances in cancer detection and prevention efforts. For this reduction in cancer death to continue, it is extremely important that we continue to prioritize efforts in cancer prevention and control. Despite the recent reduction in incidence and mortality rates, cancer remains the leading cause of mortality among those under age 85. In the US, cancer accounts for nearly 60,000 more deaths each year than heart disease, the second leading cause of death in this population (Jemal et al. 2007). Cancer is the leading health problem in the US that takes more lives among those under age 85 than any other disease or any accidental causes. Only after age 85 does heart disease surpass cancer deaths.

Cancer is a global term for a variety of diseases that are characterized by uncontrolled cellular growth, enhanced angiogenesis and/or reduced programmed cell death. The site of origin of the disease is used to define general categories of cancer (e.g. breast cancer, skin cancer). Worldwide, the incidence and mortality from cancer has been increasing, despite recent advances in the understanding and treatment of many diseases. This emphasizes the need to define the etiology and molecular basis of cancer and to prevent that cancer from developing. The concept of cancer prevention is changing gradually as we gain a greater understanding of the genetic and molecular basis of carcinogenesis. Certainly, it is understood that the cancer patient is not well one day and the next day diagnosed with cancer. It is estimated that there is an average lag of at least 20 years between the development of the first cancer cell and the onset of end-stage metastatic disease for a broad range of solid tumors. In that there were an estimated 559,650 cancer deaths in the US in 2007 (Jemal et al. 2007), and given the 20+ year lag time, more than 11 million “healthy” Americans harbor ultimately deadly cancers.