A Revolution in Cancer Prevention: From Molecular Knowledge to Technology – The ESMO President Explains

ESMO (European Society for Medical Oncology) 2024 Congress takes place in Barcelona on September 13-17, bringing together oncologists, researchers, patient advocates and healthcare industry representatives from around the world. More than 33000 oncology professionals have registered for this major event, and over 5000 scientific abstracts have been accepted for presentation.

The following article is a translation of ESMO President Andrés Cervantes's September 13, 2024 article entitled "From precision oncology to molecular prevention – a new role for our profession?".

As rapid scientific and technological advances raise hopes of preventing cancer at its earliest stages, ESMO is increasing its focus on cancer prevention to provide medical oncologists with the education and guidance needed to keep pace with this rapidly changing field.

Cancer prevention and early detection through screening are not just individual choices, but important areas for action for the entire oncology community. The global cancer burden is expected to rise by 77% by 2050 compared with 2022, exceeding 35 million new cases annually (see our related article). Population aging and growth, together with changing exposure to risk factors as socioeconomic development progresses, are cited as the main drivers. Reversing this trend is vital to protecting both our healthcare systems and patients' access to high-quality care.

Lifestyle factors such as tobacco, alcohol and obesity, along with environmental factors such as air pollution, are major causes of cancer and need to be addressed. Not all cancers can be prevented, of course, but emerging innovative technologies will allow more cancers to be detected earlier in the future. Blood-based multicancer early detection tests (MCED), artificial intelligence-assisted medical imaging and wearable devices that calculate individual cancer risk scores may help reduce cancer deaths through secondary prevention.

As our knowledge of cellular processes grows, it becomes clear that mechanisms of carcinogenesis triggered by environmental or genetic factors should guide personalized "precision prevention," just as different tumor molecular profiles guide treatment choices. For example, current standards in the United States recommend starting prostate cancer screening 10 years earlier for Black men (NEJM Evid. 2024;3).

Similarly, the human papillomavirus (HPV) vaccine is not an equally beneficial cancer prevention tool for all women, and some high-risk HPV types are not covered by existing vaccines (Cancer Epidemiol Biomarkers Prev. 2021;30:1895-1903).

Translating this new molecular knowledge and risk-stratification profiles into more effective and cost-efficient prevention strategies through cancer screening holds great promise. Through ESMO's newly established Cancer Prevention and Early Detection Task Force, we aim to provide a comprehensive view of developments and share this knowledge with the medical oncology community.

As the field matures, ESMO will continue informing oncologists about these advances and supporting their optimal integration into clinical practice. Over the next five days, the ESMO 2024 Congress will host educational sessions exploring future cancer prevention approaches alongside important scientific results.