The research programs of the NCI take place in three settings: the laboratory, the clinic, and the community. In the laboratory, research is pursued on the biology of cancer, the fundamental properties of cancer-causing agents and processes, and the body's defense against and response to cancer. In the clinic, patient-oriented research is carried out concerning prevention, detection, diagnosis, treatment, and rehabilitation. In the community, research is carried out on the causes, risks, predispositions, incidence, and behavioral aspects of cancer. As the diagram indicates, the components of this research triad interface.
For example, population- or community-based research on the effects of exposure to a potential cancer-causing agent links to the laboratory where an understanding of the agent's effect on the cell can be explored. Through these linkages, we have identified a sexually transmitted papilloma virus as a primary cause of cervical cancer and subsequently explained why only certain viral sub-types are cancer- causing; and we have established the relationship between asbestos and mesotheliomas; between reproductive variables such as late menopause and breast cancer, and between dietary factors and a variety of cancers.
Likewise, community-based research on family clusters of cancers can lead to the isolation of the specific genes responsible for inherited cancer syndromes. The identification of specific genetic pathways in cells studied in the laboratory then can be used to predict the course of a patient's disease and his or her response to therapeutic interventions, or to find ways to detect these cancers very early in their development.
There are four fundamental cancer research areas--in effect four fundamental goals of cancer research: An understanding of cancer biology; identifying who is at risk for cancer and why; developing interventions to prevent, detect, diagnose, and treat cancer, and to enhance survivorship from cancer; and bringing research discoveries to the public and to practice.
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