Cancer prevention as our first best hope: Action in prevention research and cancer control

Ernest T. Hawk, M.D., M.P.H., University of Texas MD Anderson Cancer Center

As many as one-half of all cancers are preventable based on what we already understand. Despite many promising and innovative new therapies, cancer prevention remains “Plan A,” our first and best hope to reduce the burden of this disease. I recently shared key points of this plan, described below, in a June 1, 2015 lecture at the American Society of Clinical Oncology Annual Meeting.

At The University of Texas MD Anderson Cancer Center, we established the cancer prevention and control platform within the Moon Shots program. Our mission is to develop and implement evidence-based actions in cancer prevention, screening, early detection and survivorship in clinical and community settings to achieve a measurable and lasting reduction in the cancer burden.

This is only made possible by translating basic science research discoveries into risk assessment tools and novel interventions, which must then put into action at both the individual and population levels.

Research at MD Anderson and other institutions has revealed that cancer usually progresses in a lengthy process from an observable pre-cancerous stage to advanced disease over several years. Further, we have learned that the disease results from a complex web of inherited and environmental factors, all of which contribute to an individual’s cancer risk. Thus, there is a window of opportunity to reduce cancer incidence through screening, lifestyle modification and preventive intervention long before a diagnosis is made.

Some of these environmental factors include tobacco use, ultraviolet (UV) exposure, unhealthy diets, and lack of physical activity. Within MD Anderson, we offer a range of evidence-based services and educational programs to provide for individual risk assessment, screening and early detection, and beneficial lifestyle changes.

At the population level, our cancer prevention and control activities aim to deliver evidence-based activities in the areas of public policy, education and community-based clinical services to improve public health behaviors.

Starting with our own population, we enacted the EndTobacco™ initiative to substantially reduce the impact of tobacco use through actions such as tobacco-free hiring at MD Anderson. EndTobacco™ represents an unprecedented institutional commitment to advance tobacco control at the local, regional, state, national and international levels.

We have additionally leveraged our expertise in cancer prevention research and clinical care to serve as a resource for policy makers as they discussed state-wide measures to restrict minors’ access to tanning beds and, most recently, prohibit the sale of e-cigarettes to minors. Both of these measures are critical in protecting the health of our young people.

With a particular focus on youth, we have partnered with the CATCH Global Foundation to promote childhood education at reducing cancer risks before those behaviors are developed. We aim to further enhance and more broadly disseminate the CATCH youth obesity-prevention program as well as expand the curriculum to include tobacco use prevention and UV protection components.

We are connecting with community health providers to facilitate clinical prevention and care service delivery beyond the walls of our hospital, particularly to underserved populations. One example, Project ECHO, enables us to provide cervical cancer screening and treatment along the Texas-Mexico border through a unique “telementoring” program to assist local health care providers in caring for their patients.

Today’s challenges in cancer prevention include an aging population, a growing prevalence of obesity and a diverse array of modifiable environmental risk factors. In addition, the research funding crisis, both in the US and globally, has created a particularly competitive environment for cancer prevention and control scientists.  This is because the vast majority of funding continues to support research related to the biology and treatment of cancer as opposed to cancer prevention and control.

We continue to rely on evidence-based programs and interventions gained from basic science research to facilitate successful cancer prevention and control activities. Continued funding and support for these fields is critical to ensure that prevention remains “Plan A” to make a lasting impact on the cancer burden.


Dr. Hawk is vice president and head of Cancer Prevention and Population Sciences at The University of Texas MD Anderson Cancer Center. He also holds the Boone Pickens Distinguished Chair for Early Prevention of Cancer and serves as executive director of the Duncan Family Institute. He co-leads the cancer prevention and control platform for MD Anderson’s Moon Shots Program. He was recently awarded the ASCO – American Cancer Society award for his efforts in cancer prevention and control at the 2015 American Society of Clinical Oncology Annual Meeting. The topics covered in this post were the focus of his award lecture, held June 1, 2015.

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Luck shouldn't play a role in why I'm alive.
Laurie MacCaskill, a seven-year pancreatic cancer survivor