Cancer Prevention: Lessons Learned and Future Directions

Our plain-English summary of Cancer Prevention: Lessons Learned and Future Directions, by B.K. Dunn, B.S. Kramer (Trends in Cancer, 2016).

The study

• Authors: B.K. Dunn, B.S. Kramer
• Journal: Trends in Cancer
• Published: 2016;2(12):713-722
• Type of article: Review
• Cited by: 14 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

In this review, we address selected areas that are central to the state-of-the-art of cancer prevention science. The emphasis on prevention as a viable and critical approach to decreasing cancer mortality has gained traction in recent years, evidenced by its inclusion in the US Vice President's Cancer Initiative (also termed 'Moonshot'). Cancer prevention occurs by arresting, slowing down, or reversing the carcinogenic process before invasion into surrounding tissue or by avoiding or blocking causative exposure. An important challenge is to identify individuals who will benefit most from preventive interventions with the least possible harm. Preventive interventions range from avoiding known carcinogens (e.g., tobacco or asbestos) to intervening with anticarcinogenic strategies (behavioral modifications , such as diet and exercise; medications; nutritional agents; and vaccination against causative agents). Here, we focus on active intervention with measures involving pharmaceutical and immunological agents.

In plain English

This article was a review, not a new study. The authors, from the US National Cancer Institute, discussed selected areas of cancer prevention science, focusing on drugs and vaccines given to people before cancer develops. Asbestos appeared only once, as an example of a known carcinogen that people can avoid. The review did not report any data or findings about asbestos, mesothelioma or other asbestos-related disease. Most of the review described earlier trials by other researchers. For example, it reported that in the NSABP Breast Cancer Prevention Trial, tamoxifen reduced invasive breast cancer risk by 49% at 69 months among 13 388 high-risk women. It noted that concerns about side effects limit the use of such drugs. It also described vaccines against hepatitis B and human papillomavirus (HPV), and aspirin and other anti-inflammatory drugs for colorectal cancer. The authors concluded that successes in cancer prevention have been achieved. They also wrote that risk models must be refined to better identify the people for whom the balance of benefit and risk is best.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative review of cancer prevention research (no new data collected)
• Who was studied: No study population of its own; the review discussed published trials and laboratory studies of drugs and vaccines for cancer prevention
• Exposure: Asbestos was mentioned only as an example of a known carcinogen to avoid. The review's subject was preventive drugs (such as tamoxifen, raloxifene, aromatase inhibitors, aspirin and metformin) and vaccines, not asbestos exposure.
• Main results:
  • The review cited the NSABP Breast Cancer Prevention Trial, an earlier study by other researchers. In that trial, tamoxifen reduced invasive breast cancer risk by 49% at 69 months among 13 388 high-risk women.
  • The review stated that concerns about tamoxifen's side effects, especially endometrial cancer and blood clots in the veins, are barriers to its use for prevention.
  • The review stated that none of the breast cancer prevention trials of these drugs had enough statistical power to show a reduction in breast cancer deaths.
  • The review reported that national HPV vaccination programs were followed by decreases in HPV prevalence in girls and women in the targeted age group.
• The authors' conclusion: The authors concluded that successes in cancer prevention have been achieved. They also concluded that risk models must be refined to better identify the people who are suitable candidates for preventive interventions.

Topics

Medical terms in this study, explained in our Lexicon: Carcinogenic.

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