title: Cancer prevention as part of precision medicine: 'plenty to be done'.
abstract: Cancer burden worldwide is projected to rise from 14 million new cases in 2012 to 24 million in 2035. Although the greatest increases will be in developing countries, where cancer services are already hard pressed, even the richest nations will struggle to meet demands of increasing patient numbers and spiralling treatment costs. No country can treat its way out of the cancer problem. Consequently, cancer control must combine improvements in treatment with greater emphasis on prevention and early detection. Cancer prevention is founded on describing the burden of cancer, identifying the causes and evaluating and implementing preventive interventions. Around 40-50% of cancers could be prevented if current knowledge about risk factors was translated into effective public health strategies. The benefits of prevention are attested to by major successes, for example, in tobacco control, vaccination against oncogenic viruses, reduced exposure to environmental and occupational carcinogens, and screening. Progress is still needed in areas such as weight control and physical activity. Fresh impetus for prevention and early detection will come through interdisciplinary approaches, encompassing knowledge and tools from advances in cancer biology. Examples include mutation profiles giving clues about aetiology and biomarkers for early detection, to stratify individuals for screening or for prognosis. However, cancer prevention requires a broad perspective stretching from the submicroscopic to the macropolitical, recognizing the importance of molecular profiling and multisectoral engagement across urban planning, transport, environment, agriculture, economics, etc., and applying interventions that may just as easily rely on a legislative measure as on a molecule.
authors.forename: Bernard W
authors.initials: BW
authors.lastname: Stewart
authors.affiliation: International Agency for Research on Cancer, 69008 Lyon, France and.
authors.forename: Freddie
authors.initials: F
authors.lastname: Bray
authors.affiliation: International Agency for Research on Cancer, 69008 Lyon, France and.
authors.forename: David
authors.initials: D
authors.lastname: Forman
authors.affiliation: International Agency for Research on Cancer, 69008 Lyon, France and.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Ohgaki
authors.affiliation: International Agency for Research on Cancer, 69008 Lyon, France and.
authors.forename: Kurt
authors.initials: K
authors.lastname: Straif
authors.affiliation: Noncommunicable Diseases and Mental Health, World Health Organization, 1121 Geneva 27, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Ullrich
authors.affiliation: International Agency for Research on Cancer, 69008 Lyon, France and director@iarc.fr.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Wild
mesh_terms: D014943:Global Health; D006801:Humans; D009369:Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D057285:Precision Medicine / Q000379:methods*