Chemoprevention & risk-reducing surgery
Drugs or surgery for people at high inherited risk, before any cancer appears.
Tamoxifen/raloxifene/anastrozole halve breast cancer incidence in high-risk women (uptake is low). Aspirin reduces colorectal cancer in Lynch syndrome (CAPP2). Risk-reducing mastectomy and salpingo-oophorectomy in BRCA carriers; opportunistic salpingectomy for the general population. Prophylactic gastrectomy in CDH1 carriers.
How it works
Remove the at-risk tissue or block the hormonal/inflammatory driver of carcinogenesis.
- Large absolute risk reduction in carriers
- Side effects deter uptake; surgery is irreversible
People with Lynch syndrome should be offered daily aspirin, which roughly halves bowel cancer risk with a delayed and durable effect. Whether a lower dose (as tested in CAPP3) is as effective, and whether the finding extends to the general population, are separate questions.
For women at raised risk, a 5-year course of tamoxifen offers long-lasting protection against the commonest kind of breast cancer. Uptake is low because of side effects and fear of rare serious harms; low-dose tamoxifen (TAM-01) is now being tested to improve the balance. It has not been shown to save lives.
Latest papers
topQuery for this technology: (TITLE:"chemoprevention" OR ABSTRACT:"chemoprevention" OR TITLE:"risk-reducing surgery" OR ABSTRACT:"risk-reducing surgery" OR TITLE:"cancer prevention" OR ABSTRACT:"cancer prevention"). Results are unfiltered search hits about Chemoprevention & risk-reducing surgery, not a curated reading list.
Pages like this
not linked directly; found by shared links- Key paperPROSE consortium: preventive surgery lowers cancer and death in BRCA1 and BRCA2 carriers
Shares A bone drug to prevent breast cancer in BRCA1 carriers, Population germline screening for hereditary cancer genes with cascade testing, Inherited risk is mostly unidentified, BRCA1 / BRCA2 (HRD).
- TechnologyGermline (hereditary) testing
Shares Cancer interception vaccines, Population germline screening for hereditary cancer genes with cascade testing, Cancer interception vaccines for high-risk carriers, Judy E. Garber.
- TermObesity-related cancers (IARC list of 13)
Shares Risk factor, Bariatric surgery and cancer incidence, GLP-1 receptor agonists and obesity-related cancer risk, Prevention we already have is not deployed.
- Key paperFirst trial of a vaccine against the shared neoantigens of mismatch-repair-deficient cancers
Shares Cancer interception vaccines, Cancer interception vaccines for high-risk carriers, Lynch syndrome, Inherited risk is mostly unidentified.
- Key paperIARC verdict: excess body fat causes 13 cancers
Shares A delivery-science moonshot for prevention we already own, A trial of GLP-1 weight-loss drugs with cancer as the primary outcome, Prevention we already have is not deployed, Ovarian cancer.
- PersonMary-Claire King
Shares Judy E. Garber, Angelina Jolie, Inherited risk is mostly unidentified, BRCA1 / BRCA2 (HRD).
- TermGermline vs somatic mutations
Shares Population germline screening for hereditary cancer genes with cascade testing, CAPP2: two years of aspirin cuts bowel cancer in Lynch syndrome by more than a third over 10 years, Angelina Jolie, Lynch syndrome.
- IdeaA randomised trial of a shared-antigen vaccine to prevent Lynch syndrome cancers
Shares Nouscom, Cancer interception vaccines for high-risk carriers, Inherited risk is mostly unidentified, Prevention we already have is not deployed.