EPIDEMIOLOGY, BIOLOGY, AND CHEMOPREVENTION OF AERODIGESTIVE CANCER

Cancers of the aerodigestive tract are a major cause of worldwide morb idity and mortality. Long term survival rates for these epithelial can cers have not improved substantially in the past 20 years despite inte nsive efforts to improve the prevention and therapy of these diseases. Therefore, new approaches are needed. One new investigative approach is chemoprevention, the chemical prevention of cancer. Chemoprevention studies in the upper aerodigestive tract have focused on the reversal of premalignant lesions and the prevention of second primary tumors. These chemoprevention efforts have resulted from an understanding of t he multistep nature of epithelial carcinogenesis and the diffuse epith elial injury that results from carcinogen exposure. Ongoing research e fforts are attempting to define these processes. The interaction betwe en carcinogen exposure and host susceptibility in the development of c ancers of the aerodigestive tract is being evaluated (e.g., with an as say of chromosomal sensitivity to the clastogen bleomycin). This revie w discusses several new aspects of the epidemiology, biology, and chem oprevention of aerodigestive tract carcinogenesis.