Abstract
Ten million new cancer patients are diagnosed worldwide each year. There will be a dramatic increase over the next 20 years in the number of people contracting cancer, especially in the developing, poorer part of the world. Many types of cancer vary in incidence and mortality by more than an order of magnitude between different populations, and every type is rare in some part of the world, suggesting that cancers are in principle preventable. Many specific causes of cancer are known, from factors related to lifestyle, diet, infections and occupations. The remarkable advances in molecular understanding of the carcinogenesis process over the past 25 years have transformed the approaches in cancer control. About 15% of cancers worldwide are caused by known infectious agents. Human papillomavirus vaccines, which are already being tested, may, in the long run, be able to prevent almost all cervical cancers. New promising disciplines in prevention, such as chemoprevention, have emerged. Chemoprevention has been successfully achieved in numerous animal experiments, and has been validated in several clinical trials. But more effective and safer chemopreventive agents and vaccines are needed. Rising prices of medicines and vaccines are putting them beyond the reach of many people, even in rich countries. Future enhanced efforts on an international basis are needed to guarantee access to these lifesaving drugs and vaccines. Putting prevention high on the agenda requires political courage and a long-term perspective.
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