Future directions in cancer prevention

In the past three decades, the approach to cancer prevention has moved from population and epidemiological studies to molecular targeting and immunological approaches and to identifying high-risk pre-cancerous lesions in individuals using emerging early detection technologies.Global implementation of these scientifically-sound lifestyle- and medical-based cancer prevention strategies has the potential to reduce worldwide cancer incidence, prevalence and mortality rates in the decades ahead.As more is learned about the mechanisms and pathways that are influenced by genetic and molecular changes that initiate cancer or encourage its progression, targeted therapies are being developed to interrupt these processes. Additional strategies are specifically focused on interrupting the late-stage, but still pre-malignant, processes that lead to in situ cancers, with the goal of averting progression to actual invasive cancer.The success of vaccines for human papilloma virus (HPV)- and hepatitis B virus (HBV)-related cancers has led to an increased focus on immunologically based research for many other cancers. Efforts are ongoing to develop immune response modulation strategies to augment the innate immunity and to develop vaccines against oncogenic infectious agents, as well as tumour-associated and tumour-specific antigens.The groundwork for the future of cancer prevention is currently being developed through multidisciplinary initiatives that involve researchers from tradition biology-based laboratories, as well as collaborators from the fields of information technology, imaging technologies, '-omics' (such as genomics, proteomics and metabolomics) and communication. Expertise in communication is essential to disseminate research findings to the communities that are likely to benefit from these findings. Inherent to this future progress is a focus on precision (individualized) medicine that will include identifying those who are at a high risk of developing cancer.