Foreword: Cancer Prevention Can Start Early and Last a Lifetime

As the nation’s health protection agency, the Centers for Disease Control and Prevention (CDC) works to protect the health and safety of all Americans. The CDC is perhaps best known for its efforts to prevent and control infectious diseases. It also strives to reduce the burden of chronic diseases, which have emerged as the leading causes of premature disability and death in the United States.1 In fact, cancer is the leading cause of death among persons aged <80 years,2 and each year, >1.5 million people are told they have cancer.3 Although the complex process of carcinogenesis is not fully understood, research suggests that it may be possible to prevent, delay, or reverse the development of many cancers by influencing various biologic systems and environmental factors that operate over a person’s lifetime.4,5 To prevent chronic diseases such as cancer, the CDC supports cross-cutting strategies that include epidemiology and surveillance, policy and environmental approaches, health care interventions, and linkages between communities and clinical services.1Within the CDC, the Division of Cancer Prevention and Control works with national cancer organizations, state health agencies, and other key groups to develop, implement, and promote effective strategies for preventing and controlling cancer.6 The Cancer Prevention Across the Lifespan workgroup of the Division of Cancer Prevention and Control seeks to answer the following fundamental question: what more could the CDC do in collaboration with its various partners to reduce the incidence of cancer in the United States? Our approach is to review the scientific literature and engage scientific experts both within and outside of the CDC to explore new opportunities for primary prevention of cancer at different stages of life.7 Early life, defined roughly as the prenatal period through early childhood, is increasingly being recognized as a critical period for cancer development and cancer prevention efforts.8,9This special supplement to Pediatrics captures our initial exploration of opportunities for cancer prevention in early life. In this undertaking, we benefited from the generous contributions of leading scientists who thoughtfully shared their knowledge and perspectives and participated in a transdisciplinary exchange of ideas. Experts were identified to reflect knowledge regarding a diversity of cancer risk factors and early life as a period of unique vulnerability for cancer development. These experts shared our desire to translate the latest scientific findings regarding cancer causation and prevention into public health practice. In a series of webinars held over 1 year, we engaged experts in discussions to help clarify our understanding of the scientific literature and its application for public health. The article by Holman et al10 summarizes the themes that emerged from those discussions. Other articles in this special supplement were contributed by participants in the webinars, and they expand on specific topics. Collectively, these articles offer some intriguing and provocative insights to inform future efforts to address cancer prevention in early life from a population perspective.