Lifestyle and medical approaches to cancer prevention.

Abstract

Cancer risk can be reduced by adopting a healthy lifestyle and by medical means. Tobacco control is central to public policies for cancer prevention. Overweight and obesity in the United States may contribute to 20% of cancer deaths in women and 14% in men. Cancer prevention strategies have progressed from a predominant lifestyle approach to a model that combines clinical investigations in a medical setting with public health interventions. This change stems from advances in identifying, developing, and testing agents with the potential either to prevent cancer initiation, or to inhibit or reverse the progression of premalignant lesions to invasive cancer. Encouraging laboratory and epidemiologic studies, along with secondary endpoints in treatment trials, have provided a strong scientific rationale for the hypothesis that a pharmacologic approach--chemoprevention--can reduce cancer risk. Numerous chemopreventive agents, including naturally occurring vitamins, minerals, phytochemicals, and synthetic compounds, have proved to be safe and effective in preclinical and clinical studies. Promising results have been reported for cancers of the prostate, breast, colon, lung, bladder, cervix, oral cavity, esophagus, skin, and liver. The use of emerging technologies, identification of biomarkers of risk, and advances in genetic research are being applied to chemoprevention research. An interdisciplinary research approach to investigate molecular and genetic markers--as well as chemoprevention and lifestyle strategies--that affect cancer risk is being applied to the most common types of cancer in the United States in women (breast) and men (prostate).