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History and Mission

The Division of Cancer Prevention's mission is to plan, direct, implement, and monitor cancer research and training that is focused on early detection, cancer risk, chemoprevention, and supportive care.

DCP projects address the need to identify where a person is in the process of carcinogenesis, and to determine ways to actively intervene to stop it from becoming invasive cancer. Varied approaches are supported, from pre-clinical discovery and development of biomarkers and chemoprevention agents, including pharmaceuticals and micronutrients, to Phase III clinical testing. Programs are harmonized with other NCI divisions, NIH institutes, and federal and state agencies.

Among its major activities, the division coordinates an integrated clinical trials research network through the Community Clinical Oncology Program (CCOP). This arrangement involves more than 4,000 physicians in NCI prevention, control and treatment trials at more than 400 community based hospitals, clinics, and practices.

DCP's Early Detection Research Network (EDRN) brings together scientists from wide ranging disciplines devoted to translating new molecular knowledge into practical clinical tests that identify cancer at the earliest stages of a normal cell's transformation. The consortium, which speeds its collaborations through an advanced informatics infrastructure, boasts more than 30 institutions and research teams from academic, private, and governmental bodies.

The Rapid Access to Preventive Intervention Development (RAPID) Program makes DCP contract resources available to academic and academically-affiliated investigators for preclinical and early clinical drug development.

NCI formally included cancer prevention in its research portfolio after it was congressionally mandated by the creation of the National Cancer Program in 1971. This vital element has since reflected the evolving scientific understanding of cancer and pre-cancer processes. While it has held different names through the years, the current NCI Division of Cancer Prevention with its distinctive multilateral approach originated in October 1997.

A stream of cancer prevention and control advancements occurred during the early decades as the science expanded. In 1974, NCI for the first time awarded cancer control grants to state health departments to screen low-income women for ovarian cancer. In 1983, funding was provided to 62 community clinical oncology centers, which became a new network for physicians called the Community Clinical Oncology Program (CCOP). Their focus was to enroll patients on NCI clinical trials that were led by cooperative groups and cancer centers. In 1986, this network grew to incorporate large-scale cancer prevention and control trials.

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In 1990, the CCOP program aimed to increase minority populations' access to cancer clinical trials, and NCI funded the first 12 minority-based community clinical oncology centers. In 1993, the largest ever cancer clinical trial to test screening effectiveness in reducing mortality from prostate, lung, colorectal, and ovarian cancers, the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO), began recruiting 148,000 men and women ages 55 to 74 years old.

That same year, the Prostate Cancer Prevention Trial (PCPT) was launched to determine whether the drug finasteride could prevent prostate cancer in men aged 55 and older. Ultimately, 18,882 men participated, and the trial ended early in 2003 with a clear finding that finasteride reduced the incidence of prostate cancer. However, trial participants who did develop prostate cancer while taking finasteride experienced a slightly higher incidence of high-grade tumors.

Another milestone was the 1998 approval by the Food and Drug Administration of the first agent for cancer risk reduction, tamoxifen, for breast cancer based on results from NCI-funded clinical trials. Results of the Breast Cancer Prevention Trial showed that women taking tamoxifen had 45 percent fewer breast cancer diagnoses than women on placebo, proving that this cancer could be prevented in high risk women. In 1999, the Study of Tamoxifen and Raloxifene (STAR), funded by DCP, began recruiting 22,000 postmenopausal women at increased risk of breast cancer to determine whether raloxifene was as effective as tamoxifen at reducing the chance of developing breast cancer. In 2006, initial results of STAR showed that the drug raloxifene is as effective as tamoxifen in reducing the breast cancer risk of the women on the trial with fewer major side effects.

The cancer prevention research structure broadened in 1999 when DCP awarded $8 million in grants to launch the Early Detection Research Network (EDRN), a national, multidisciplinary scientific consortium to discover, develop, and validate biomarkers for early detection and identification of cancer risk.

The early 21st Century saw the start of two major clinical trials. Recruiting of 32,400 men began in 2001 for the largest ever prostate cancer prevention study, the Selenium and Vitamin E Cancer Prevention Trial (SELECT). With DCP funding to the Southwest Oncology Group, the trial seeks to determine if the two dietary supplements can protect against prostate cancer. Later that year, DCP and the American College of Radiology Imaging Network established the first large, multicenter study to compare digital mammography to standard mammography to detect breast cancer. In 2002, the National Lung Screening Trial (NLST), aimed at recruiting 50,000 people, was initiated to compare two ways of testing for early lung cancer in current and former heavy smokers: spiral computed tomography and single-view chest x-ray.

In 2005, early results from the first-year of prostate, colon, lung, and ovarian cancer screenings within the PLCO trial were published. That same year, the first major validation testing of a biomarker to identify individuals at risk for liver cancer commenced. Also in 2005, data from the Women's Intervention Nutrition Study (WINS) showed that in postmenopausal women diagnosed with breast cancer, a very low-fat diet can improve the outcome of breast cancer therapy.

In 2006, DCP's $350 million program continued to generate new information about effective chemoprevention agents, screening methods and technologies, early detection biomarkers, molecular processes vulnerable to prevention interventions, and mechanistically targeted nutrients.

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