The Nation's Investment in Cancer Research
A Plan and Budget Proposal for Fiscal Year 2008
Prepared by the Director, National Cancer Institute as mandated by The National Cancer Act (P.L. 92-218)
Accelerating Progress in Cancer Prevention
We will accelerate the discovery, development, and delivery of cancer prevention interventions by focusing on risk assessment, systems biology, behavior modifications, environmental and policy influences, medical and nutritional approaches, and training and education for research and health professionals.
Today's Research
Prevention is our first line of defense against cancer. NCI's portfolio supports research to identify medical and behavioral approaches to cancer prevention that can be applied in public health settings. Examples of ongoing NCI research include:
- Understanding the role of nutrients and micronutrients in human health and cancer occurrence
- Developing prevention vaccines to stimulate the immune system to attack cancer cells or cancer-causing agents
- Identifying effective vaccine delivery strategies
- Developing drugs to prevent primary and secondary cancers
- Investigating behavioral factors that affect cancer risk and developing strategies to change these behaviors
- Exploring complementary and alternative methods for cancer prevention
Tomorrow's Strategies
Research must identify the most promising advances and translate them into new prevention approaches. NCI will broaden and strengthen its prevention portfolio with a rigorous agenda:
- Support a systematic review of epidemiologic evidence on possible carcinogens and risk factors for cancer.
- Develop and promote the adoption of medical interventions, including nutritional approaches, chemoprevention drugs, and prevention vaccines that suppress cancer initiation and progression.
- Develop and test behavioral approaches for reducing cancer risk.
- Study the impact of environmental and policy interventions on cancer risk.
- Explore the biology behind successful cancer prevention interventions through a transdisciplinary systems approach.
- Evaluate the impact of knowledge and intervention dissemination and diffusion programs for cancer prevention using an outcome monitoring system.
- Train scientists, clinicians, and other health professionals for cancer prevention research.
Moving Research Forward
…with Cancer Chemoprevention Studies
Chemoprevention is the use of natural or synthetic substances to reduce the risk of developing cancer, or to reduce the chance that cancer will recur. Chemoprevention trials look at possible ways to prevent cancer with interventions that include drugs, vitamins, diet, hormone therapy, or other agents. NCI's chemoprevention research effort, started in the early 1980s, is yielding exciting results. For example, based on findings of the NCI Breast Cancer Prevention Trial, the U.S. Food and Drug Administration approved tamoxifen for reducing the incidence of breast cancer in women at high risk for the disease. This success confirms the usefulness of large-scale chemoprevention clinical trials for identifying ways to stop many of the people at risk for cancer from becoming cancer patients.
…and Progress in Pursuit of our Goal
- Results of the Study of Tamoxifen and Raloxifene (STAR) Trial. STAR, the largest breast cancer chemoprevention trial ever conducted, compared two selective estrogen receptor modulators (SERMs). These drugs work by blocking the tumor-promoting effects of estrogen that are seen in about two-thirds of breast cancer patients. STAR findings show that the anti-osteoporosis (anti-bone thinning) drug raloxifene (Evista®) reduces breast cancer risk in postmenopausal women as well as tamoxifen. Moreover, raloxifene appears less likely to cause some of the rare but serious side effects seen with tamoxifen, such as uterine cancer. These findings are promising because this combination of effective treatment and reduced chance of serious side effects may be what is needed to make breast cancer prevention more of a reality for many women.
- SELECT (the Selenium and Vitamin E Cancer Prevention Trial). Previous studies suggest that the mineral selenium and vitamin E (alone or in combination) may reduce the risk of prostate cancer. Only a large clinical trial, such as the NCI SELECT, can confirm those initial findings. SELECT finished enrolling patients in June 2004, with 35,534 participants. The trial is expected to end by 2011.
- Finasteride Follow-up Studies. In June 2003, the Prostate Cancer Prevention Trial (PCPT) was stopped early because of a clear finding that finasteride reduced the incidence of prostate cancer. However, men who did develop prostate cancer while taking finasteride experienced a slightly higher incidence of high-grade tumors. Follow-up studies are investigating whether finasteride actually caused high-grade tumors.
NCI also is supporting chemoprevention research to benefit patients at high risk for other cancers, including colorectal, lung, esophageal, bladder, cervical, and oral cavity cancer.
