Cancer chemoprevention

Chemopreventive agents show promise for preventing and reversing cancer development Chemoprevention of cancer aims to prevent, arrest, or reverse either the initiation phase of carcinogenesis or the progression of neoplastic cells to cancer. It has been an active area of research for several decades; the use of retinoids to prevent cancer of the head and neck is a notable example.1 Chemoprevention is widely used and readily accepted by doctors and patients in the form of drugs that lower cholesterol concentrations and blood pressure to reduce the risk of cardiovascular disease. It can also be used in some apparently healthy people at risk of cancer to prevent or reduce their risk of developing invasive disease. The biomedical community needs to recognise and advocate approaches to prevent cancer with the same enthusiasm that it currently directs towards treating it. Summary points Cancer is a multistage disease, not a single event, and doctors should emphasise cancer prevention in addition to cancer treatment and cure Chemoprevention with naturally occurring (many dietary) and synthetic agents shows promise for preventing, arresting, and reversing cancer development Chemopreventive agents must have low toxicities compared with chemotherapeutic agents used in cancer patients Physicians should identify patients at high risk of cancer who might benefit from participation in chemoprevention trials Validation of surrogate endpoint biomarkers for clinical cancer is essential to reduce size and duration of chemoprevention trials