The recent approval of a vaccine that protects against infection by four types of human papillomavirus (HPV), thus preventing the cause of approximately 70 percent of cervical cancer cases, provides an excellent reminder of how our research efforts in the United States stand to benefit millions of people around the world. Approximately 80 percent of cervical cancer cases occur in the developing world, so the availability of this vaccine, as well as other HPV vaccines in development, will have a major impact on international public health.

That reality was driven home repeatedly for me this past week at the International Union Against Cancer (UICC) meeting, the world's largest independent, nonprofit association of organizations dedicated to battling cancer, which includes everything from patient and survivor support and advocacy groups to large nongovernmental organizations engaged in a broad spectrum of activities in cancer screening, prevention, and treatment.

This year's meeting is being held back to back with another important international meeting, the World Conference on Tobacco OR Health. The two meetings, which will host a veritable who's who of international biomedical researchers, display the rapidly growing global burden presented by cancer, as well as the intense commitment of international health leaders to making rapid progress to overcome this disease.

This afternoon at the UICC conference, I had the honor of serving on a panel to discuss the future of cancer care. I spoke about research areas where we will see significant progress by the end of the decade: understanding the importance of the tumor microenvironment, the role of cancer stem cells in resistance to therapy, and vaccine therapy for prevention.

Advances in our understanding of the biology of these areas, coupled with our ability to genetically characterize patients and their tumors, will one day completely change how oncologists care for cancer patients. For example, although research into cancer stem cells is a relatively young field, they may offer a novel therapeutic target. There is a growing body of evidence from laboratory and animal-model studies to support the theory that these self-perpetuating cancer cells drive tumor development and growth, and may be the source of cancer's ability to return after apparently being decimated by ablative and cytotoxic therapies.

I was joined on the panel by Dr. Clem Bezold, the president and founder of the Institute for Alternative Futures, and Dr. Eduardo Cazap, the president of the Latin American and Caribbean Society of Medical Oncology, both of whom gave intriguing talks and offered some important perspectives.

Dr. Bezold predicted that over the next two decades, utilizing biomonitoring, cancer care in the United States will shift towards early detection, primary and secondary prevention, and a greater emphasis on healthy lifestyles.

And Dr. Cazap noted that, although developed countries are seeing some significant advances in cancer care, cancer rates in developing countries are rapidly increasing. Political commitments and prioritized interventions that are most appropriate for local conditions, he argued, are needed to improve worldwide cancer health disparities.

International meetings such as the UICC are important, not just because they offer excellent educational opportunities, but because they serve to strengthen the global bonds of the cancer research community - something to which NCI is deeply committed.

It's clear that the worldwide public health threat posed by cancer is formidable. Fortunately, in countries around the globe, there is no shortage of energy, ideas, and talent among those committed to tackling this challenge.

Dr. John E. Niederhuber
Acting Director
National Cancer Institute