Prevention of cancer in the next millennium: Report of the Chemoprevention Working Group to the American Association for Cancer Research

D. S. Alberts, O. M. Colvin, A. H. Conney, V. L. Ernster, J. E. Garber, P. Greenwald, L. J. Gudas, Ki Hong Waun Ki Hong, G. J. Kelloff, R. A. Kramer, C. E. Lerman, D. J. Mangelsdorf, A. Matter, J. D. Minna, W. G. Nelson V, J. M. Pezzuto, F. Prendergast, V. W. Rusch, M. B. Sporn, L. W. WattenbergI. B. Weinstein

Research output: Contribution to journalArticle

162 Scopus citations

Abstract

The incidence and mortality rates for most of the common forms of cancer are still unacceptably high. This stark fact in itself is a strong argument for further research, both basic and clinical, to prevent cancer. The new science of chemoprevention, defined as the use of pharmacological or natural agents to inhibit the development of invasive cancer, has been established as a promising new strategy to achieve this goal. In the area of basic science, immense advances in the understanding of the molecular and cellular biology of the process of carcinogenesis (the development of cancer) now provide a rational basis for further progress in cancer chemoprevention. Clinical studies have validated the use of new drugs both for prevention of first cancers (primary prevention), as well as for prevention of new cancers in patients who have had surgery for removal of a malignancy (secondary prevention). The development of new and better drugs for chemoprevention remains a principal need. Toward this goal, it is essential to understand the molecular and cellular mechanism of action of such drugs, as well as to develop accurate biomarkers to assess their efficacy. The introduction of new drugs for chemoprevention will require new cooperative efforts among the academic community, the pharmaceutical industry, and government agencies such as the NCI and FDA. The implementation of chemoprevention also requires that important societal concerns be addressed. These include concerns about genetic testing, confidentiality of medical data, and the appropriateness of treating people who are free of symptomatic disease. A major educational effort involving patient advocacy groups, as well as the pharmaceutical industry, the government, and the academic community, will be required to achieve the promise of widespread chemoprevention. Finally, the development of chemoprevention as both a basic and a clinical science will require a major increase in funding and institutional resources, if we are to achieve these goals. There is a compelling need for funding to attract young professionals, both M.D.s and Ph.D.s, to choose a career in this field. There is a specific major need for further funding for clinical trials of new chemopreventive agents. 'Proof of principle' for chemoprevention as a practical approach to the control of cancer now exists. The challenge now is to increase our efforts to achieve the worldwide benefit that would result from the prevention of cancer.

Original languageEnglish (US)
Pages (from-to)4743-4758
Number of pages16
JournalCancer Research
Volume59
Issue number19
StatePublished - Oct 1 1999
Externally publishedYes

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ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Alberts, D. S., Colvin, O. M., Conney, A. H., Ernster, V. L., Garber, J. E., Greenwald, P., Gudas, L. J., Waun Ki Hong, K. H., Kelloff, G. J., Kramer, R. A., Lerman, C. E., Mangelsdorf, D. J., Matter, A., Minna, J. D., Nelson V, W. G., Pezzuto, J. M., Prendergast, F., Rusch, V. W., Sporn, M. B., ... Weinstein, I. B. (1999). Prevention of cancer in the next millennium: Report of the Chemoprevention Working Group to the American Association for Cancer Research. Cancer Research, 59(19), 4743-4758.