ABSTRACT
Despite major advances in early diagnosis and cancer treatment, mortality from cancer remains a significant public health concern in most developed countries. In the past two decades, the focus of medicine in the public health arena has evolved from disease treatment to risk reduction and, ultimately, prevention. Advances inmolecular biology, genetics, drug discovery, and imaging technology have given way to a more sophisticated understanding of the etiology and development of disease. Elucidation of the multiple molecular steps of carcinogenesis involving a continuum of DNA damage (Vogelstein et al., 1988; Fearon, 1990) and enhanced detection of precancerous conditions has given rise to the prospect that the carcinogenic process might somehow be averted, incapacitated, or even reversed. This concept has been demonstrated by several recent clinical trials, several of which will be discussed here, but is still in its initial stages of development.
