Screening and Early Detection

Although substantial progress is currently being made in the development of novel and more effective therapeutics, cancer remains a largely unsolved clinical problem with high mortality. Cancer incidence is on the rise in the United States and worldwide. Between 2005 and 2015, the number of cancer cases increased by 33%, owing in part to population aging, which contributed 16%, and population growth and changes in age-specific rates, which contributed the remainder. Cancer incidence and the societal cancer burden are expected to increase further. Beyond therapeutics, substantial reduction in cancer mortality necessitates improved understanding of cancer risk, implementation of effective preventive intervention strategies, and early detection of cancers that are likely to progress to avoid the problem of overdiagnosis, all of which represent substantial challenges that can be overcome. Identifying individuals at increased risk of developing a particular cancer type would allow for a range of preventive interventions to be implemented, from altered lifestyle and health behaviors to the use of vaccines, and early detection of particular cancer(s) for which these persons are at risk. A case in point is obesity, which is a risk factor for at least 13 different cancers. Elucidation of metabolic, immune, and other molecular profiles that contribute to the increased risk would allow for more focused screening strategies for persons with these risk profiles and would allow implementation of targeted prevention strategies aimed at the cancer(s) for which they are at risk.