Precancer Workshop Sponsored by Division of Cancer Biology, NCI and Department of Pathology, George Washington University Medical School November 8-9, 2004 Overview – Jules Berman, Ph.D., M.D., Cancer Diagnosis Program, NCI
Precancers are the morphologically identifiable lesions that precede invasive cancers. __ agree __ disagree
In theory, the identification and elimination of precancers would lead to the eradication of most human cancers. __ agree __ disagree
Most clinicians and health provider organizations already have a good understanding of what lesions are precancers and what lesions are not precancers. __ agree __ disagree
Most researchers have a pretty good idea of the biologic properties that distinguish precancers from fully developed cancers. __ agree __ disagree
Precancers do not exist as entitities separable from cancers. The lesions that are called precancers are really just small or early cancers that have not yet invaded or metastasized. __ agree __ disagree
Precancers exist but most of the lesions people label as precancers are spontaneously regressing foci, and not truly precancerous. __ agree __ disagree
Another term for precancer is intraepithelial neoplasia. Therefore, the concept of precancers is narrow, applying only to some epithelial tumors. __ agree __ disagree
The term "precancer" includes different biological classes of lesions. For instance, adenomas, myelodysplasias, microscopic intraepithelial neoplasias, and diffuse atypical hyperplasias are all very different classes of precancers. __ agree __ disagree
There is no need to develop a comprehensive precancer classification. It’s already been done by the WHO. __ agree __ disagree
It is not generally worthwhile to screen for precancers because the small subset of precancers that will progress to cancer can't be distinguished from the non-progressing lesions. __ agree __ disagree
Prophylactic chemotherapy makes no sense for precancers. Nobody will accept chemotherapy for a tumor that they don’t yet have. __ agree __ disagree
It is not worthwhile trying to develop surgical methods to excise precancers. There are too many of them and most are not easily detectable or amenable to surgical treatment. __ agree __ disagree
The precancers are not suitable lesions for research. They are so small that it is impossible to obtain enough tissue for useful experimental studies. __ agree __ disagree
There are currently no useful mouse models for human precancers. Mice are short- lived animals with an accelerated carcinogenesis pathway that does not typically involve an identifiable precancer lesion. __ agree __ disagree
At this time, there is no regulatory infrastructure that will permit us to develop treatment protocols for the precancers. __ agree __ disagree
When you eliminate a precancer, you’re preventing the occurrence of a cancer. Therefore, methods of treating precancers fall under the general area of cancer prevention, not cancer treatment __ agree __ disagree
If you treat a precancer with medicine or surgery, you are treating a neoplastic condition, and this research falls in the general area of cancer treatment, not cancer prevention. __ agree __ disagree
The National Cancer Institute already supports precancer research and provides funds commensurate with the importance of the field. __ agree __ disagree
The purpose of Workshop Establish Precancer as a distinct area of scientific research with its own set of: 1. basic biologic principles 2. fundamental research questions 3. translational research objectives and has proven ability to reduce the number of cancer deaths.