Cancer statistics paint a daunting and seemingly overwhelming picture. One out of every two men and two out of every three women will be diagnosed with cancer during their lives. Nearly 25 percent of all deaths in the United States result from cancer, and medical expenses for cancer cost our nation up to $60 billion a year. With our aging population, the number of people diagnosed with cancer is expected to double from 1.3 million in 2000 to 2.6 million by 2050.
With recent advances in cancer research, however, a comprehensive solution to the problem of cancer is increasingly within reach. The National Cancer Institute (NCI), the federal government's primary organization for cancer research, is in the forefront of that effort. We both conduct and fund research on multiple fronts, from basic laboratory studies to large clinical trials involving thousands of patients. Just as importantly, we strive to close the gap between basic research and the translation of the knowledge that we gain from it into practical help for patients at risk for, diagnosed with, or recovering from cancer.
Perhaps our greatest hope lies in the emerging understanding of cancer at the genetic, molecular, and cellular levels. More than 5,000 NCI investigators, working alone or in groups, have embarked on an incredibly challenging intellectual exercise. Their ultimate goal is to treat each cancer tumor according to its unique genetic and molecular fingerprint.
"The paradigm I grew up with as an oncologist was to find cancer and kill it," said NCI Director Andrew von Eschenbach. "Now, we look forward not only to eradicating cancer, but also to modulating and altering the behavior of the disease. This new paradigm uses biology-based interventions to detect, treat, and prevent cancers."
In the coming years, NCI will focus much of its efforts on a halfdozen areas that we believe offer extraordinary potential: genes and the environment, cancer imaging, molecular signatures and targeting, tobacco-related cancers, and cancer communications.
GENES AND THE ENVIRONMENT
Exactly how genetic and environmental factors interact to cause cancer remains a complex puzzle. Mutations in some genes, such as that for familial adenomatous polyposis, are so powerful that carriers are almost certain to develop colon cancer. Mutations in other genes, such as BRCA1 and BRCA2, are just some of the many risk factors for breast cancer. Certain environmental factors, such as smoking, are strong but not absolute predictors of cancer.
NCI investigators are working on identifying the cancer risks associated with the interaction between certain environmental exposures and genetic factors. With this better understanding, we can check genetic susceptibility, identify treatments for people at high risk, and develop strategies to avoid adverse exposures. We are also working toward more patient-friendly tools, with such non-invasive methods as screening for lung cancer by sputum samples or sampling DNA from cheek cells.
Various ongoing studies are helping to build the large databases needed to formulate prevention and treatment options. Currently, we are collecting not only data on environmental exposures, but also actual tissue, blood, and other body-fluid samples from some 700,000 study participants. Because genes play such a significant role in the development of cancer, we are tracking cancer trends among 14,000 families enrolled in cancer registries that record family history, demographics, and lifestyle risk factors.
This past summer, NCI reported its findings on a lengthy study -- a decade-long investigation into possible environmental causes of elevated breast-cancer mortality rates in Long Island, NY, and surrounding areas. Researchers looked at the current and past exposure of 1,508 local women to contaminated drinking water; air pollution, electromagnetic fields, and other suspected hazards. The study found a negligible connection. …