The Division of Cancer Prevention conducts and supports research to determine a person's risk of developing cancer and to find ways to reduce that risk. Through laboratory, clinical, and epidemiologic research, scientists have shown that the diseases of cancer occur not as single, catastrophic events, but rather as the result of a complex and long-evolving molecular process that can take decades. This long-term process of carcinogenesis provides time and opportunities to slow down, stop, or reverse the cellular changes that can become cancer.
The Path from Healthy to Cancer
To transform into invasive cancer, healthy tissue usually develops abnormalities, including a complex variety of both genetic and epigenetic changes that occur at different times over the lifespan. The intervals between initiation of the cancer process and occurrence of the invasive disease vary by organ and tissue sites; some may take decades. The Division's research portfolio focuses across this span, with a goal to detect changes and intervene early in the cancer process to prevent disease and death. A speculated timeline for various cancers appears below.
Prevention Agent Development
The Chemopreventive Agent Development Research Group supports the identification and development of prevention agents with the potential to block, reverse, or delay the early stages of cancer. The group administers the PREVENT Cancer Preclinical Drug Development Program, a partnership to facilitate development of cancer preventive drugs, including new drugs and repurposed drugs, immunopreventive vaccines, and surrogate biomarkers.
Early Phase Prevention Trials
The organ systems research groups (below) develop and support clinical cancer prevention studies and trials evaluating promising new agents, biomarkers to measure efficacy of interventions, and new technologies to identify premalignant lesions. The Phase 0/I/II Cancer Prevention Trials Program functions out of these groups.
Clinical Trials in Prevention and Cancer Control
The Community Oncology and Prevention Trials Research Group invests community physicians in clinical trials, via the NCI Community Oncology Research Program (NCORP). NCORP is responsible for the implementation of NCI's large cancer prevention clinical trials and cancer control studies, including symptom management, toxicity reduction, supportive and palliative care, and quality of life changes caused by cancer or cancer treatment. Investigator-initiated grants in supportive and palliative care are also supported outside of NCORP.
Biomarkers for Early Detection of Cancer
The Cancer Biomarkers Research Group promotes research to identify, develop, and validate biological markers for early cancer detection and cancer risk assessment. Activities include development and validation of promising cancer biomarkers, collaborative databases and informatics systems, and new technologies or the refinement of existing technologies. The Early Detection Research Network and the Alliance of Glycobiologists for Detection of Cancer are administered here.
Early Detection Trials
The Early Detection Research Group supports research that seeks to determine the effectiveness, operating characteristics and clinical impact (harms as well as benefits) of cancer early detection technologies and practices, such as imaging and molecular biomarker approaches. The Cancer Data Access System (CDAS), a submission and tracking system for the use of data and images from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial and the National Lung Screening Trial is managed here.
The Nutritional Science Research Group promotes and supports studies establishing a comprehensive understanding of the precise role of diet and food components in modulating cancer risk and tumor cell behavior. This includes approaches to characterize molecular targets and variability in individual responses to nutrients and dietary patterns. Basic, translational, and clinical studies are supported to understand the interplay between nutrition and the microbiome, the underlying mechanisms implicated in cancer prevention, and the interplay between genetics, gene expression, and dietary intake.
Biostatistical Modeling and Collaborative Support
The Biometry Research Group plans and conducts studies in biostatistical and epidemiological methodologies and mathematical modeling of processes relevant to cancer prevention. Collaborations focus on cancer epidemiology, prevention, screening, and diagnosis.