In this issue of the NCI Cancer Bulletin, we offer a closer look at cancer prevention research. It's an enormous topic, but I think you'll see as you read that, beyond what we already know about behavior change and cancer prevention, the field is transitioning toward studies that delve into the molecular foundations of health and disease.

Some of the most promising science under way takes advantage of advances in fields such as genomics, transcriptomics, proteomics, and metabolomics - what some call "molecular prevention."

In the following pages, for example, you'll see that researchers are investigating the genetic and epigenetic events related to carcinogenesis and their interplay with diet and environmental exposures; they are conducting whole-genome scans using genomic single nucleotide polymorphisms (SNPs) and beginning the use of whole genome sequencing to identify all of the genes predicting risk and involved in the development of cancer; and they are using genetically engineered mouse models that may be able to provide important details about precancerous states and possibly accelerate the development of preventive agents, such as those supported by the Division of Cancer Prevention's RAPID program, which expedites extramural agents through development, proof of concept, and phase I clinical trials.

I see a close relationship between research focused on preventing disease in those known to be at high risk and detecting disease at its very earliest stages based on genetic or protein expression signatures. Research such as this is going on throughout NCI, including the Early Detection Research Network, the Clinical Proteomics Program, and the Cancer Family Registries, with opportunities for the cross-fertilization of ideas that can lead to important advances.

Any discussion of cancer prevention would be incomplete without highlighting the recent approval of the vaccine that protects against human papilloma virus (HPV). The benefits of this vaccine will probably not be seen for years to come, so it is imperative that all women continue regular screening.

Along those lines, during a visit to the Ohio State University Comprehensive Cancer Center last week, I attended a presentation on an innovative study called CARE aimed at addressing the unusually high cervical cancer rates in the Appalachian regions of Ohio by, among other measures, improving Pap smear screening rates.

The program highlights that access to cutting-edge science and care is critical to decreasing the cancer burden. That reality is a driver behind the pilot program to be launched later this year, the NCI Community Cancer Centers Program. And, of course, continuing to support innovative ways to influence behavioral risk factors, including diet, exercise, and tobacco use, remains a key part of cancer prevention.

I hope you enjoy this special issue. It provides only a snapshot of the diverse efforts by NCI and others in the research community to prevent cancer. But I believe it also presents a bright future in which we have a variety of effective tools at our disposal to fight cancer incidence and vastly improve public health in the United States and beyond.

Dr. John E. Niederhuber
Director, National Cancer Institute