CANCER PREVENTION - PAST, PRESENT, FUTURE

There are many examples of different types of cancers that have been p revented by appropriate measures in the past. Most of them were relate d to occupational, iatrogenic or accidental factors, often as the outc ome of heavy exposure of humans to specific carcinogenic agents. Cance r is a disease of DNA, and is generally associated with multiple genet ic alterations, these being produced in the typical case by exposure t o various carcinogens, each of which exists at minute concentrations. Thus, the impact of carcinogenic factors, xenobiotics and autobiotics, is due to their actions in concert. However, a single mutation yieldi ng genomic instability exerts a disproportionately large influence by resulting in a large number of secondary mutational events. Epigenetic changes can also not be disregarded especially from the view point of prevention of neoplasia. The occurrence of multiple primary cancers a mong survivors of initial primaries, and the presence of hereditary gr oups with a high risk of cancer development provide a strong stimulus for establishment of effective approach for cancer prevention, which s hould be, in principle, multi-faceted. Therefore, a holistic approach is essential with improvement in life style includings choosing a bala nced diet and avoidance of cigarette smoking and other sources of carc inogens, as integral elements. (C) 1998 Elsevier Science B.V. All righ ts reserved.