Basic science research could greatly improve cancer prevention efforts

Many are aware of the importance of cancer research for the discovery of new therapies and treatment options, but perhaps less well-known is the impact of this research on the field of cancer prevention.

Significant cancer prevention, control and screening efforts, together with treatment advances, have resulted in a 25 percent drop in the U.S. cancer death rate since 1991, according to the American Cancer Society. However, there will still be an estimated 1.7 million new cancer cases diagnosed — and more than 600,000 deaths from the disease — this year.

Current evidence suggests that up to half of all cancers are associated with preventable risk factors such as tobacco use and ultraviolet (UV) radiation, and basic science research has revealed the molecular mechanisms by which these factors can promote cancer development.

According to a new review article from researchers at MD Anderson Cancer Center, improving the implementation of established prevention and screening measures would result in near-term improvements in cancer incidence and mortality; while additional investment in prevention-oriented research by basic scientists could serve to further advance cancer prevention in the long term.

The review, published in the June 25 issue of Genes & Development, was authored by Ernest Hawk, M.D., vice president and division head for Cancer Prevention and Population Sciences, and Paul Scheet, Ph.D., associate professor of Epidemiology, together with colleagues from Fox Chase Cancer Center, the Broad Institute, Oxford University and MIT.

“Our intent for the review is to raise awareness of the impact of cancer prevention research among basic scientists, highlighting the incredible opportunity we see for improving cancer outcomes,” Hawk says. “Further investment in this area will help us to better understand early cancer development, enabling us to develop more and better preventive interventions to amplify the benefits that healthy lifestyles offer today.”

The review summarizes several topics within the cancer prevention space, including known risk factors for cancer, genetic predisposition to cancer, and screening and early detection methods. The review also provides insight into specific research that led to the current state of knowledge in these fields.

The authors conclude by discussing the possible impact of cancer prevention through the optimal uptake of healthy lifestyle changes, implementation of public health policies and adoption of recommended screening practices.

“Based on our current understanding, following evidence-based methods of cancer prevention, namely modifiable risk factors, could reduce cancer incidence by 30 to 50 percent, and reduce cancer deaths over the next few decades by 50 percent or more,” Scheet says. “For example, modifying risk factors such as tobacco use, physical inactivity, excessive weight, diet, infection and UV radiation can have profound effects.”

The authors note that cancer prevention efforts represent an important complement to the development of new therapeutic approaches for treating established cancers and are likely to result in greater impacts on future cancer incidence and mortality.

"If additional investments in prevention-oriented basic science are as successful as we imagine they could be, we’ll need fewer resources devoted to advanced cancer treatment going forward, simply as a result of our success,” Hawk says. “Cancer treatment will always be needed, but with more emphasis on prevention and early detection, we would expect those treatments both to be less often necessary and more often effective. Additionally, the potential improvements to our population’s health stand as compelling reasons for establishing prevention research and implementation as national priorities.”