title: Cancer chemoprevention: Much has been done, but there is still much to do. State of the art and possible new approaches.
abstract: Over the past three decades great efforts have been made in search of cancer chemoprevention strategies. The increase in knowledge of the long process from normal to cancer cell has enabled interventions in terms of lifestyle modifications, natural compounds or drugs to block or reverse the process. Great successes have been achieved, especially for breast and colorectal cancer. However, these strategies have yet to find clinical application on a large scale. In this article we identify the achievements, the pitfalls and the next steps to be taken to improve the efficacy and applicability of chemoprevention strategies. Among the crucial key points to be implemented are educational activities for physicians to appropriately disseminate the aim and indeed the culture of chemoprevention. It is essential to improve the risk-benefit balance, seeking the minimal active doses, intermittent schedules, a better characterization of the risk categories via a more personalized intervention based on individual characteristics, and ensure the containment of costs of public and private health prevention programs.
authors.affiliation: Division of Cancer Prevention and Genetics, European Institute of Oncology, Milan, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Serrano
authors.affiliation: Division of Cancer Prevention and Genetics, European Institute of Oncology, Milan, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Lazzeroni
authors.affiliation: Division of Cancer Prevention and Genetics, European Institute of Oncology, Milan, Italy. Electronic address: bernardo.bonanni@ieo.it.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Bonanni
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000627:therapeutic use; D019496:Cancer Vaccines / Q000627:therapeutic use; D018890:Chemoprevention; D020847:Estrogen Receptor Modulators / Q000627:therapeutic use; D006801:Humans; D008687:Metformin / Q000627:therapeutic use; D009369:Neoplasms / Q000517:prevention & control*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D047072:Aromatase Inhibitors; D019496:Cancer Vaccines; D020847:Estrogen Receptor Modulators; D008687:Metformin
keywords: Chemoprevention; Surrogate-biomarkers; Vaccines