Strategies toward the primary prevention of cancer. Lucy Wortham James clinical research award lecture

E. L. Wynder
American Health Foundation, New York, NY 10017.

This presentation reflects four decades of research on the origins and prevention of major human cancers linked to tobacco use and nutritional factors. Observations in the 1950s went on to prove the causal relationship between cigarette smoking and lung cancer. Attempts to lower the cancer risk by product modification have shown some promise, but an absolute risk reduction can be attained only by abstinence from tobacco use. The role of dietary fat as a risk factor for breast cancer is highlighted as an example of the link between nutrition and cancer. Preventive strategies of dietary modification need to delineate the roles of specific types of dietary fats in mammary carcinogenesis. Low-fat diets in conjunction with chemotherapy and ovarian ablation may even be effective in preventing metastasis or recurrence of breast cancer after surgery in premenopausal patients. Health education in schools and health promotion efforts involving all segments of the community need to be pursued as primary preventive strategies for cancer control, along with efforts to ward product modification and research on chemoprevention of cancer.