Tumor Prevention and Genetics

Hans-Jorg Senn H.-J. Senn (~) Center for Tumor Detection and Prevention, Rorschacherstr. 150, CH-9006 St. Gallen, Switzerland Clinical oncology has centered mainly on developing new strategies and a multitude of new drugs for fighting relapsing and progressive cancer during the last two decades. Furthermore, it has done this with respectable success in quite a number of neoplastic diseases such as acute leukemias and sarcomas in pediatric patients and certain types of aggressive lymphomas, as well as se­ lected solid tumors such as testicular cancer and choriocarcinoma in adult age. Curatively intended adjuvant chemo-and endocrine-therapies of several "main killers" among prevalent cancer types, especially breast and colon can­ cer, have also become successful and health-politically meaningful therapeutic targets [1, 2]. However, the net gain in "cure" of these (mostly pharmacologic) therapeu­ tic approaches has to be realistically judged as having a moderate impact on the cancer problem as a whole, and the mortality rate of the most frequent tu­ mor types, which are prevalent in adult life, has with very few exceptions not been substantially decreased over the past two to three decades. Increasingly, health politicians, epidemiologists, and medical journal editors are asking for alternative strategies of lowering cancer incidence and increasing survival, ventilating new and hitherto mostly neglected areas of research such as pri­ mary and secondary cancer prevention.

Inhalt

1 Latest News in Cancer Genetics.- Genetic Susceptibility, Predicting Risk and Preventing Cancer.- Novel Approaches to Identify Low Penetrance Cancer Susceptibility Genes Using Mouse Models.- 2 Assessing New Cancer Susceptibility Genes.- Development of Novel Selective Cell Ablation in the Mammary Gland and Brain to Study Cell-Cell Interactions and Chemoprevention.- Mouse Skin as a Model for Cancer Chemoprevention by Nonsteroidal Anti-Inflammatory Drugs Friedrich Marks, Gerhard Fürstenberger; Gitta Neufang,.- Preclinical Models for Chemoprevention of Colon Cancer.- New Cancer Biomarkers Deriving from the NCI Early Detection Research.- 3 Update in Chemoprevention of Breast Cancer.- Tamoxifen's Impact as a Preventive Agent in Clinical Practice and an Update on the STAR Trial.- Aromatase Inhibitors in Prevention - Data from the ATAC (Arimidex, Tamoxifen Alone orin Combination) Trial and the Design of IBIS-II (The Second International Breast Cancer Intervention Study).- HRT Opposed by Low Dose Tamoxifen (HOT Study). Rationale and Design.- 4 Secondary Prevention of Breast Cancer: The Mammography Controversy.- Is Mammography Screening for Breast Cancer Really Not Justifiable?.- How Reliable is the Evidence for Screening Mammography?.- Political Interpretation of Scientific Evidence - Case Study of Breast Cancer Screening Policies Around the World.- 5 Chemoprevention of Skin and Lung Cancer.- Skin Cancer Chemoprevention: Strategies to Save our Skin.- Chemoprevention of Non-Melanoma Skin Cancer: Experience with a Polyphenol from Green Tea.- Chemoprevention of Lung Cancer: New Directions.- Key Issues in Lung Cancer Chemoprevention Trials of New Agents.- 6 Prevention and Screening of Prostate Cancer.- Prevention of Prostate Cancer.- Clinical Models for Testing Chemopreventative Agents in Prostate Cancer and Overview of SELECT: The Selenium and Vitamin ECancer Prevention Trial.- Problems with Prostate Specific Antigen Screening: A Critical Review.- 7 Prevention and Screening of Colorectal Cancer.- Genetic Predisposition as a Basis for Chemoprevention, Surgical and Other Interventions in Colorectal Cancer.- Fecal Occult Blood (FOB) Screening - Trial Evidence, Practice and Beyond Gad Rennert.- Is FOB-Screening Really the Answer for Lowering Mortality in Colorectal Cancer?.- Summary and Conclusions.