Cancer, Disease Progression and Chemoprevention, 2007

Dramatic advances in our understanding of cancer development have come from epidemiologic and laboratory animal research. The critical events occur during the early stages of the dynamic multi-step process leading to invasive cancer. Such emerging knowledge will provide further insights not only into carcinogenic processes, but also into more sensitive methods of early detection and more effective means of prevention.

In this book, we have succeeded in preparing a comprehensive, timely, and critical review of the substantial progress that has been made in our understanding of cancers, their precursors, and inhibition of these. They have enlisted experts in the field, who have contributed authoritative chapters, on the precursors to a wide variety of cancers, with emphasis on etiology and natural history, including the role of environmental factors that provoke normal cells to undergo malignant transformation. We understand that prevention of cancers is far preferable to treating the malignancies. While opportunities now exist for primary and secondary prevention of certain cancers, we are still limited by an incomplete understanding of causal factors and cancer development, including the precursor lesions that hold the key to advances in cancer prevention. As a result of conceptual breakthroughs in our understanding of the mechanisms of cancer development, however, there is growing optimism that the incorporation of molecular and genetic probes into clinical and epidemiological approaches will more fully illuminate events on the causal pathway to cancer. When identifying and deploying sensitive biomarkers of carcinogenic exposure, susceptibility genes, and intermediate outcomes, it should be possible to more precisely define individuals at elevated risk of cancer, and to design and test novel approaches to preventive interventions.

While this book presents scientific information about cancer development, its precursors, and prevention, it also indicates the complexity of the task ahead for all scientists, whose work on cancer chemosprevention may usher in new strategies to eliminate cancer before it develops and escapes control.