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Cancer chemoprevention 

Cancer chemoprevention
Chapter:
Cancer chemoprevention
Author(s):

Katja Zirlik

, Nadir Arber

, and Dirk Schrijvers

DOI:
10.1093/med/9780199656103.003.0029_update_001

Updates

An analysis from the IBIS-I study (International Breast Cancer Intervention Study I) provides evidence for a long-term protective effect in breast cancer of tamoxifen.

However, overall breast cancer mortality has not been shown to decrease in chemoprevention trials by anti-hormones conducted so far.

Prophylactic use of aspirin has a favourable risk-to-benefit profile for colorectal cancer prevention in the average-risk general populations in the developed world.

Chemoprevention by hormone-interfering drugs like finasteride and dutasteride do not have a favourable risk-to-benefit profile in order to be proposed for chemoprevention of prostate cancer among healthy men.

Updated on 29 March 2019. The previous version of this content can be found here.
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date: 24 August 2019

Cancer prevention certainly would be the best approach to cancer. Interventions should be effective, with minimal side effects, convenient, and inexpensive. Cancer chemoprevention is defined as the pharmacologic intervention with the process of carcinogenesis to prevent the development of overt malignant neoplasms in healthy individuals with elevated cancer risk. The present list of candidate cancer types for active chemoprevention is still short and includes SERMs (tamoxifen, raloxifene) and an aromatase-inhibitor (exemestane) for chemoprevention of breast cancers, showing significant reduction of cancer occurrence. The same holds true for reduction of the development of invasive cancers by aspirin, NSAIDs, and COX2-inhibitors in selected populations with increased colorectal cancer risk. There is also reduction of prostate cancers by long-term application of 5-alfa-reductase-inhibitors (finasteride, dutasteride) in selected high-risk populations. Many other potentially active anti-neoplastic compounds have been tested but do not meet all the criteria of efficiency, efficacy, and cost-effectiveness.

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