Social Responsibility in Cancer Prevention Research: IARC as a 'Global Science Force'
Ten million new cancer patients are diagnosed each year worldwide. Many specific causes of cancer are known, ranging from factors related to lifestyle, diet and chronic infections to occupational exposures. Primary and secondary prevention continue to be of major importance in cancer control globally. The global burden of cancer, especially the part attributable to infectious diseases, disproportionally affects populations in developing countries. Inadequate access to treatment (pharmaceuticals and other modern technology) plays a role in perpetuating this disparity. Drugs and vaccines may not be accessible because of excessive cost or because development of the required products has been neglected. The remarkable advances in molecular understanding of the carcinogenesis process over the past 25 years have transformed the approaches to cancer control. Promising new tools in preventive oncology, such as immunization (vaccines) and chemoprevention, have emerged. Vaccines are currently being tested in trials e.g., against hepatitis B virus and human papillomaviruses. Chemoprevention has been successfully achieved in animal experiments, and has been validated in several clinical trials. The current agents and strategies should not be regarded as a panacea; more effective and safer vaccines and chemopreventive agents are needed. Future enhanced efforts on an international basis are needed to coordinate the prevention and intervention research efforts in a cost-efficient and affordable manner. Cancer prevention deserves continuing high priority in terms of both research and application, also in the developing countries. New ventures may be built on possible expansion of IARC's role in prevention and intervention research into a "Global Science Force" by following the examples of e.g., the Gambia Hepatitis Intervention Study and the cervix cancer screening trials in India. WHO's support with its regional offices would be beneficial, together with further national funding and support, and research collaboration and funding from more wealthy countries.
Vainio
Harri
H
Unit of Chemoprevention, International Agency for Research on Cancer, Lyon, France. vainio@iarc.fr