{"entity":{"id":"prevention-roadmap","kind":"roadmap","name":"Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers","aka":[],"tldr":"About four in ten cancers could be prevented with tools that already exist: vaccines against the viruses that cause them, tobacco and alcohol control, weight, aspirin for the right people, and finding the families who carry a high-risk gene. The roadmap is mostly about deployment, with interception vaccines as the long-range bet.","summary":"Prevention has the strongest evidence and the weakest deployment in oncology. Tobacco control has prevented more cancer deaths than any drug. Hepatitis B vaccination cut liver cancer in the countries that adopted it early, and HPV vaccination is eliminating cervical cancer where coverage is high; a single dose proved almost fully protective (KEN SHE, 2021) and the WHO endorsed one-dose schedules, which makes elimination affordable everywhere. Germline testing finds the BRCA and Lynch carriers who benefit from risk-reducing surgery, aspirin and intensive screening. Tamoxifen prevents breast cancer in high-risk women.\n\nThe present decade is adding precision to prevention: aspirin after bowel cancer surgery works in tumours with PIK3CA mutations (ALASCCA) and is being tested in four cancers in Add-Aspirin, while ASPREE showed it does not help everyone; low-dose tamoxifen keeps the benefit with fewer side-effects; salpingectomy during any pelvic operation prevents ovarian cancer; polygenic scores could set when screening starts; population germline screening would find the carriers who do not know. GLP-1 agonists and bariatric surgery may prevent obesity-related cancers and need a randomised trial to prove it.\n\nThe frontier is interception: vaccinating people who carry a high-risk gene against the cancers they are likely to develop, with the Lynch syndrome frameshift vaccine as the first candidate for a randomised trial. The pace is set by the adoption gap, by funding that follows treatment rather than prevention, and by the politics of alcohol, tobacco and food.","asOf":"2026-09-10","links":[{"label":"WHO cervical cancer elimination initiative","url":"https://www.who.int/initiatives/cervical-cancer-elimination-initiative"},{"label":"KEN SHE single-dose HPV vaccine trial (NEJM Evidence 2022)","url":"https://doi.org/10.1056/EVIDoa2100056"},{"label":"ALASCCA: aspirin in PIK3CA-mutated colorectal cancer (NEJM 2025)","url":"https://www.nejm.org/doi/full/10.1056/NEJMoa2504650"}],"tags":[],"related":["uk-biobank","cure-paths","early-detection-roadmap","nutrition-lifestyle-roadmap","idea-prev-hpv-single-dose-switch-catchup","idea-prev-hpv-self-sampling-mailed-default","idea-prev-hpv-male-catchup-oropharynx","idea-single-dose-hpv-self-sampling-elimination","idea-prev-hbv-treat-all-hcc","idea-prev-hpylori-family-test-and-treat","idea-moon-eliminate-infection-cancers","idea-prev-smokefree-generation-evaluation","idea-prev-cytisine-essential-medicine","idea-prev-alcohol-cancer-warning-labels","idea-prev-glp1-cancer-prevention-rct","idea-reg-aspirin-pik3ca-implementation","idea-prev-lynch-aspirin-implementation","idea-prev-low-dose-tamoxifen-uptake","idea-prev-opportunistic-salpingectomy-default","idea-moon-population-germline-screening","idea-prev-population-germline-screening-at-30","idea-prev-cascade-direct-contact-relatives","idea-prev-reflex-germline-testing","idea-prev-prs-screening-start-age","idea-prev-prs-ancestry-portability-standard","idea-interception-vaccines","idea-prev-lynch-frameshift-vaccine-rct","idea-moon-lynch-vaccine-phase3","idea-prev-brca1-denosumab-prevention","idea-prev-chemoprevention-master-protocol","idea-prev-precursor-endpoints-for-approval","idea-fund-social-impact-bonds-prevention","idea-prev-pharmacy-prevention-hub","idea-moon-hpv-vaccine-confidence","idea-prev-radon-testing-at-property-sale","lung-cancer-evidence-roadmap"],"cancers":["lung-cancer"],"sections":["prevention"],"technologies":["hpv-vaccine","hpv-testing","precancer-ablation","germline-testing","chemoprevention","aspirin-cancer-prevention","risk-reducing-salpingectomy","polygenic-risk-scores","interception-vaccination","shared-antigen-vaccine","alcohol-reduction-labelling","smoking-cessation-after-diagnosis","glp1-agonists-cancer-risk","bariatric-surgery-cancer-incidence","hcc-surveillance","colorectal-screening","low-dose-ct-screening"],"targets":[],"drugs":["gardasil-9","cervavac","tamoxifen"],"companies":["serum-institute-of-india","myriad-genetics"],"institutions":["who","iarc","icmr-nicpr"],"pathways":[],"terms":["risk-factor","obesity-related-cancers"],"trials":["ken-she","iarc-india-hpv-dose-study","osmanabad-hpv-screening","alascca","add-aspirin","aspree","nordicc","nlst-nelson"],"people":[],"bottlenecks":["b-prevention-adoption","b-hereditary-risk","b-funding-allocation","b-incentive-misalignment","b-global-access","b-overdiagnosis"],"keyPapers":["paper-barnabas-nejm-evid"],"journals":[],"dependsOn":[],"notes":[],"steps":[{"era":"1950-2000","title":"Tobacco, hepatitis B and the first chemoprevention","description":"The link between smoking and lung cancer, established in the 1950s, produced the taxes, advertising bans and smoke-free laws that have prevented more cancer deaths than any treatment. Universal infant hepatitis B vaccination, begun in Taiwan in the 1980s, cut liver cancer in the vaccinated generation. Helicobacter pylori was identified as the cause of most stomach cancer. Tamoxifen was shown to prevent breast cancer in high-risk women in 1998, the first drug proven to stop a cancer before it starts.","refs":["risk-factor","hpv-vaccine","chemoprevention","tamoxifen","iarc","smoking-cessation-after-diagnosis"],"status":"historic"},{"era":"2006-2020","title":"HPV vaccines, hereditary testing and the elimination goal","description":"The first HPV vaccine (2006) and the nine-valent version that prevents about nine in ten cervical cancers turned an infection into a preventable one; HPV DNA testing replaced the smear and one round of it in rural India cut cervical cancer deaths (Osmanabad). Germline testing made BRCA and Lynch carriers findable, and risk-reducing surgery, aspirin (CAPP2) and intensive surveillance gave them options. In 2020 the WHO adopted a strategy to eliminate cervical cancer as a public health problem: vaccinate, screen, treat.","refs":["gardasil-9","hpv-testing","osmanabad-hpv-screening","precancer-ablation","germline-testing","myriad-genetics","risk-reducing-salpingectomy","aspirin-cancer-prevention","who","hcc-surveillance","colorectal-screening","nordicc"],"status":"historic"},{"era":"2021-2026","title":"One dose, self-sampling and vaccines made where they are needed","description":"KEN SHE showed in 2021 that a single dose of HPV vaccine is almost fully protective against the two most dangerous types, confirming what an interrupted Indian trial had suggested; the WHO endorsed one-dose schedules in 2022, halving the cost of elimination. India's Serum Institute launched its own vaccine, Cervavac. Self-collected HPV swabs and same-day thermal ablation of precancer are letting nurses run cervical programmes without colposcopy. Catch-up vaccination for men, to prevent the throat cancers that now outnumber cervical cancers in some countries, is the next policy step.","refs":["ken-she","iarc-india-hpv-dose-study","cervavac","serum-institute-of-india","hpv-testing","precancer-ablation","idea-prev-hpv-single-dose-switch-catchup","idea-prev-hpv-self-sampling-mailed-default","idea-single-dose-hpv-self-sampling-elimination","idea-prev-hpv-male-catchup-oropharynx","idea-moon-hpv-vaccine-confidence"],"status":"current"},{"era":"2022-2027","title":"Aspirin and tamoxifen for the right people","description":"ASPREE showed that daily aspirin does not help healthy older people and can harm them; ALASCCA showed that three years of low-dose aspirin roughly halves recurrence in bowel cancers carrying PIK3CA mutations; Add-Aspirin is testing it in 11,000 patients across four cancers. The lesson is that chemoprevention needs a biomarker or a defined high-risk group. Low-dose tamoxifen keeps the preventive benefit with fewer side-effects and could be prescribed by pharmacists and nurses; removing the fallopian tubes during any pelvic operation, once childbearing is finished, prevents most ovarian cancers at no extra operation.","refs":["aspree","alascca","add-aspirin","aspirin-cancer-prevention","idea-reg-aspirin-pik3ca-implementation","idea-prev-lynch-aspirin-implementation","idea-prev-low-dose-tamoxifen-uptake","risk-reducing-salpingectomy","idea-prev-opportunistic-salpingectomy-default"],"status":"current"},{"era":"2025-2030","title":"Weight, alcohol, tobacco and infection at population scale","description":"People on GLP-1 agonists have lower rates of obesity-related cancers in observational data and bariatric surgery patients develop fewer cancers; a randomised trial with cancer as the primary outcome is the most important prevention study this decade could run. Smoke-free generation laws are being enacted and need built-in evaluation; cytisine, a cheap plant-based quit-smoking pill, belongs on every essential medicines list; cancer warning labels on alcohol are a natural experiment waiting to be measured. Treating everyone with chronic hepatitis B, curing hepatitis C and family-based H. pylori test-and-treat would remove most of the remaining infection-caused cancers.","refs":["glp1-agonists-cancer-risk","bariatric-surgery-cancer-incidence","obesity-related-cancers","idea-prev-glp1-cancer-prevention-rct","idea-prev-smokefree-generation-evaluation","idea-prev-cytisine-essential-medicine","alcohol-reduction-labelling","idea-prev-alcohol-cancer-warning-labels","idea-prev-hbv-treat-all-hcc","idea-prev-hpylori-family-test-and-treat","idea-moon-eliminate-infection-cancers","idea-prev-radon-testing-at-property-sale"],"status":"emerging"},{"era":"2026-2032","title":"Inherited risk found before the cancer","description":"Most people who carry a high-risk cancer gene find out when they or a relative get cancer. The proposals: reflex germline testing for every cancer where it changes care, letting clinics contact relatives directly when a gene is found, offering everyone at 30 a test for the genes that matter, and polygenic risk scores that set when screening starts, built to work in every ancestry before they are deployed anywhere. UK Biobank is the cohort where most of these scores are being validated.","refs":["germline-testing","b-hereditary-risk","idea-prev-reflex-germline-testing","idea-prev-cascade-direct-contact-relatives","idea-prev-population-germline-screening-at-30","idea-moon-population-germline-screening","polygenic-risk-scores","idea-prev-prs-screening-start-age","idea-prev-prs-ancestry-portability-standard","uk-biobank"],"status":"emerging"},{"era":"2030+","title":"Interception: vaccinating people who do not yet have cancer","description":"Lynch syndrome tumours share frameshift neoantigens, which makes a shared vaccine possible; a randomised prevention trial in carriers would be the first preventive cancer vaccine that is not against a virus. A bone drug (denosumab) may prevent BRCA1 breast cancers by hitting the cells they grow from. A master protocol for chemoprevention across many precancers, and regulators accepting shrinkage of precancer as an endpoint, would make prevention drugs developable at all. The bar is high: healthy people accept risk today for a probabilistic benefit years later.","refs":["interception-vaccination","shared-antigen-vaccine","idea-interception-vaccines","idea-prev-lynch-frameshift-vaccine-rct","idea-moon-lynch-vaccine-phase3","idea-prev-brca1-denosumab-prevention","idea-prev-chemoprevention-master-protocol","idea-prev-precursor-endpoints-for-approval","cure-paths"],"status":"speculative"},{"era":"What sets the pace","title":"Deployment, funding and politics","description":"Around four in ten cancers are preventable with tools we already own, and the gap is deployment, not discovery. Prevention has no product to sell, so funding follows treatment; the commercial determinants of alcohol, tobacco and food are politically defended; and screening brings overdiagnosis that has to be managed rather than ignored. Community pharmacies as prevention hubs and social impact bonds repaid from avoided treatment costs are two ways to pay for what is already proven.","refs":["b-prevention-adoption","b-funding-allocation","b-incentive-misalignment","b-global-access","b-overdiagnosis","idea-prev-pharmacy-prevention-hub","idea-fund-social-impact-bonds-prevention","icmr-nicpr"],"status":"current"}],"watch":[]},"route":"/roadmaps/prevention-roadmap/","neighbours":{"collection":[{"id":"uk-biobank","kind":"collection","name":"UK Biobank","route":"/collections/uk-biobank/"}],"roadmap":[{"id":"nutrition-lifestyle-roadmap","kind":"roadmap","name":"Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment","route":"/roadmaps/nutrition-lifestyle-roadmap/"},{"id":"early-detection-roadmap","kind":"roadmap","name":"Early detection roadmap: organ screening → blood tests for many cancers","route":"/roadmaps/early-detection-roadmap/"},{"id":"gallbladder-cancer-roadmap","kind":"roadmap","name":"Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials","route":"/roadmaps/gallbladder-cancer-roadmap/"},{"id":"global-access-roadmap","kind":"roadmap","name":"Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation","route":"/roadmaps/global-access-roadmap/"},{"id":"lung-cancer-evidence-roadmap","kind":"roadmap","name":"Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch","route":"/roadmaps/lung-cancer-evidence-roadmap/"},{"id":"cure-paths","kind":"roadmap","name":"Paths to cures: interception, eradication, control","route":"/roadmaps/cure-paths/"}],"idea":[{"id":"idea-prev-brca1-denosumab-prevention","kind":"idea","name":"A bone drug to prevent breast cancer in BRCA1 carriers","route":"/ideas/idea-prev-brca1-denosumab-prevention/"},{"id":"idea-moon-lynch-vaccine-phase3","kind":"idea","name":"A frameshift neoantigen vaccine for Lynch syndrome carriers as the first preventive cancer vaccine approval","route":"/ideas/idea-moon-lynch-vaccine-phase3/"},{"id":"idea-prev-lynch-frameshift-vaccine-rct","kind":"idea","name":"A randomised trial of a shared-antigen vaccine to prevent Lynch syndrome cancers","route":"/ideas/idea-prev-lynch-frameshift-vaccine-rct/"},{"id":"idea-prev-glp1-cancer-prevention-rct","kind":"idea","name":"A trial of GLP-1 weight-loss drugs with cancer as the primary outcome","route":"/ideas/idea-prev-glp1-cancer-prevention-rct/"},{"id":"idea-prev-reflex-germline-testing","kind":"idea","name":"Automatic germline testing for every cancer type where it changes care","route":"/ideas/idea-prev-reflex-germline-testing/"},{"id":"idea-prev-prs-ancestry-portability-standard","kind":"idea","name":"Build polygenic scores that work in every ancestry before deploying any","route":"/ideas/idea-prev-prs-ancestry-portability-standard/"},{"id":"idea-interception-vaccines","kind":"idea","name":"Cancer interception vaccines for high-risk carriers","route":"/ideas/idea-interception-vaccines/"},{"id":"idea-prev-alcohol-cancer-warning-labels","kind":"idea","name":"Cancer warnings on alcohol labels, evaluated as a natural experiment","route":"/ideas/idea-prev-alcohol-cancer-warning-labels/"},{"id":"idea-prev-hpv-male-catchup-oropharynx","kind":"idea","name":"Catch-up HPV vaccination for men to prevent throat cancer","route":"/ideas/idea-prev-hpv-male-catchup-oropharynx/"},{"id":"idea-prev-pharmacy-prevention-hub","kind":"idea","name":"Community pharmacies as one-stop cancer prevention hubs","route":"/ideas/idea-prev-pharmacy-prevention-hub/"},{"id":"idea-moon-hpv-vaccine-confidence","kind":"idea","name":"Community-tailored HPV vaccine confidence campaigns with school-based delivery","route":"/ideas/idea-moon-hpv-vaccine-confidence/"},{"id":"idea-moon-eliminate-infection-cancers","kind":"idea","name":"Eliminate infection-caused cancers: HPV, hepatitis B and C, H. pylori and EBV","route":"/ideas/idea-moon-eliminate-infection-cancers/"},{"id":"idea-prev-hpylori-family-test-and-treat","kind":"idea","name":"Family-based H. pylori test-and-treat to prevent stomach cancer","route":"/ideas/idea-prev-hpylori-family-test-and-treat/"},{"id":"idea-crc-early-onset-cause-hunt","kind":"idea","name":"Find out what is driving early-onset bowel cancer, starting with colibactin, before extending screening any further","route":"/ideas/idea-crc-early-onset-cause-hunt/"},{"id":"idea-reg-aspirin-pik3ca-implementation","kind":"idea","name":"Get biomarker-directed aspirin after colorectal surgery into labels and guidelines","route":"/ideas/idea-reg-aspirin-pik3ca-implementation/"},{"id":"idea-prev-lynch-aspirin-implementation","kind":"idea","name":"Get every Lynch syndrome carrier onto the right dose of aspirin","route":"/ideas/idea-prev-lynch-aspirin-implementation/"},{"id":"idea-prev-cascade-direct-contact-relatives","kind":"idea","name":"Let clinics contact relatives directly when a cancer gene is found","route":"/ideas/idea-prev-cascade-direct-contact-relatives/"},{"id":"idea-prev-low-dose-tamoxifen-uptake","kind":"idea","name":"Low-dose tamoxifen for high-risk women, prescribed by pharmacists and nurses","route":"/ideas/idea-prev-low-dose-tamoxifen-uptake/"},{"id":"idea-prev-radon-testing-at-property-sale","kind":"idea","name":"Mandatory radon testing when homes are sold, with subsidised mitigation","route":"/ideas/idea-prev-radon-testing-at-property-sale/"},{"id":"idea-prev-population-germline-screening-at-30","kind":"idea","name":"Offer everyone at 30 a test for the cancer genes that matter","route":"/ideas/idea-prev-population-germline-screening-at-30/"},{"id":"idea-prev-chemoprevention-master-protocol","kind":"idea","name":"One master trial for cancer prevention drugs across many precancers","route":"/ideas/idea-prev-chemoprevention-master-protocol/"},{"id":"idea-moon-population-germline-screening","kind":"idea","name":"Population germline screening for hereditary cancer genes with cascade testing","route":"/ideas/idea-moon-population-germline-screening/"},{"id":"idea-prev-hpv-self-sampling-mailed-default","kind":"idea","name":"Post every woman an HPV self-test kit instead of asking her to book a smear","route":"/ideas/idea-prev-hpv-self-sampling-mailed-default/"},{"id":"idea-prev-cytisine-essential-medicine","kind":"idea","name":"Put cytisine, a cheap plant-based quit-smoking pill, on every essential medicines list","route":"/ideas/idea-prev-cytisine-essential-medicine/"},{"id":"idea-prev-precursor-endpoints-for-approval","kind":"idea","name":"Regulators accept shrinking of precancer as the endpoint for prevention drug approval","route":"/ideas/idea-prev-precursor-endpoints-for-approval/"},{"id":"idea-prev-opportunistic-salpingectomy-default","kind":"idea","name":"Remove the fallopian tubes during any pelvic surgery once childbearing is finished","route":"/ideas/idea-prev-opportunistic-salpingectomy-default/"},{"id":"idea-single-dose-hpv-self-sampling-elimination","kind":"idea","name":"Single-dose HPV vaccination plus HPV self-sampling to reach WHO elimination in low-income countries","route":"/ideas/idea-single-dose-hpv-self-sampling-elimination/"},{"id":"idea-prev-smokefree-generation-evaluation","kind":"idea","name":"Smoke-free generation laws with a built-in evaluation across countries","route":"/ideas/idea-prev-smokefree-generation-evaluation/"},{"id":"idea-fund-social-impact-bonds-prevention","kind":"idea","name":"Social impact bonds for cancer prevention, repaid from avoided treatment costs","route":"/ideas/idea-fund-social-impact-bonds-prevention/"},{"id":"idea-prev-hpv-single-dose-switch-catchup","kind":"idea","name":"Switch every country to single-dose HPV vaccination and add catch-up to age 26","route":"/ideas/idea-prev-hpv-single-dose-switch-catchup/"},{"id":"idea-prev-hbv-treat-all-hcc","kind":"idea","name":"Treat everyone with chronic hepatitis B to prevent liver cancer","route":"/ideas/idea-prev-hbv-treat-all-hcc/"},{"id":"idea-lung-never-smoker-disease-its-own-programme","kind":"idea","name":"Treat lung cancer in never-smokers as its own disease, with its own detection programme","route":"/ideas/idea-lung-never-smoker-disease-its-own-programme/"},{"id":"idea-prev-prs-screening-start-age","kind":"idea","name":"Use a polygenic risk score to set when screening starts","route":"/ideas/idea-prev-prs-screening-start-age/"}],"cancer":[{"id":"lung-cancer","kind":"cancer","name":"Lung cancer (all types)","route":"/cancers/lung-cancer/"}],"section":[{"id":"prevention","kind":"section","name":"Prevention & Risk","route":"/fronts/prevention/"}],"technology":[{"id":"alcohol-reduction-labelling","kind":"technology","name":"Alcohol reduction, pricing and cancer warning labels","route":"/technologies/alcohol-reduction-labelling/"},{"id":"aspirin-cancer-prevention","kind":"technology","name":"Aspirin for cancer prevention and adjuvant therapy","route":"/technologies/aspirin-cancer-prevention/"},{"id":"bariatric-surgery-cancer-incidence","kind":"technology","name":"Bariatric surgery and cancer incidence","route":"/technologies/bariatric-surgery-cancer-incidence/"},{"id":"interception-vaccination","kind":"technology","name":"Cancer interception vaccines","route":"/technologies/interception-vaccination/"},{"id":"chemoprevention","kind":"technology","name":"Chemoprevention & risk-reducing surgery","route":"/technologies/chemoprevention/"},{"id":"colorectal-screening","kind":"technology","name":"Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood)","route":"/technologies/colorectal-screening/"},{"id":"germline-testing","kind":"technology","name":"Germline (hereditary) testing","route":"/technologies/germline-testing/"},{"id":"glp1-agonists-cancer-risk","kind":"technology","name":"GLP-1 receptor agonists and obesity-related cancer risk","route":"/technologies/glp1-agonists-cancer-risk/"},{"id":"hcc-surveillance","kind":"technology","name":"HCC surveillance in cirrhosis (ultrasound + AFP)","route":"/technologies/hcc-surveillance/"},{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV vaccination","route":"/technologies/hpv-vaccine/"},{"id":"hpv-testing","kind":"technology","name":"HPV DNA testing and self-sampling","route":"/technologies/hpv-testing/"},{"id":"low-dose-ct-screening","kind":"technology","name":"Low-dose CT lung screening","route":"/technologies/low-dose-ct-screening/"},{"id":"shared-antigen-vaccine","kind":"technology","name":"Off-the-shelf cancer vaccines","route":"/technologies/shared-antigen-vaccine/"},{"id":"polygenic-risk-scores","kind":"technology","name":"Polygenic risk scores for cancer","route":"/technologies/polygenic-risk-scores/"},{"id":"risk-reducing-salpingectomy","kind":"technology","name":"Risk-reducing and opportunistic salpingectomy","route":"/technologies/risk-reducing-salpingectomy/"},{"id":"smoking-cessation-after-diagnosis","kind":"technology","name":"Smoking cessation in cancer patients","route":"/technologies/smoking-cessation-after-diagnosis/"},{"id":"precancer-ablation","kind":"technology","name":"Thermal ablation and cryotherapy for cervical precancer","route":"/technologies/precancer-ablation/"}],"drug":[{"id":"cervavac","kind":"drug","name":"CERVAVAC (quadrivalent HPV vaccine, India)","route":"/drugs/cervavac/"},{"id":"gardasil-9","kind":"drug","name":"Nonavalent HPV vaccine","route":"/drugs/gardasil-9/"},{"id":"tamoxifen","kind":"drug","name":"Tamoxifen","route":"/drugs/tamoxifen/"}],"company":[{"id":"myriad-genetics","kind":"company","name":"Myriad Genetics","route":"/companies/myriad-genetics/"},{"id":"serum-institute-of-india","kind":"company","name":"Serum Institute of India","route":"/companies/serum-institute-of-india/"}],"institution":[{"id":"icmr-nicpr","kind":"institution","name":"ICMR-National Institute of Cancer Prevention and Research","route":"/institutions/icmr-nicpr/"},{"id":"iarc","kind":"institution","name":"International Agency for Research on Cancer (IARC / WHO)","route":"/institutions/iarc/"},{"id":"who","kind":"institution","name":"World Health Organization Cancer Programme","route":"/institutions/who/"}],"term":[{"id":"obesity-related-cancers","kind":"term","name":"Obesity-related cancers (IARC list of 13)","route":"/terms/obesity-related-cancers/"},{"id":"risk-factor","kind":"term","name":"Risk factor","route":"/terms/risk-factor/"}],"trial":[{"id":"add-aspirin","kind":"trial","name":"Add-Aspirin","route":"/trials/add-aspirin/"},{"id":"alascca","kind":"trial","name":"ALASCCA","route":"/trials/alascca/"},{"id":"aspree","kind":"trial","name":"ASPREE (ASPirin in Reducing Events in the Elderly)","route":"/trials/aspree/"},{"id":"iarc-india-hpv-dose-study","kind":"trial","name":"IARC India HPV vaccine dose study (one, two or three doses)","route":"/trials/iarc-india-hpv-dose-study/"},{"id":"ken-she","kind":"trial","name":"KEN SHE (single-dose HPV vaccine)","route":"/trials/ken-she/"},{"id":"nlst-nelson","kind":"trial","name":"NLST & NELSON (low-dose CT screening)","route":"/trials/nlst-nelson/"},{"id":"nordicc","kind":"trial","name":"NordICC (Nordic-European Initiative on Colorectal Cancer)","route":"/trials/nordicc/"},{"id":"osmanabad-hpv-screening","kind":"trial","name":"Osmanabad cervical screening trial (HPV testing vs cytology vs VIA)","route":"/trials/osmanabad-hpv-screening/"}],"bottleneck":[{"id":"b-funding-allocation","kind":"bottleneck","name":"Funding follows fashion, not burden","route":"/bottlenecks/b-funding-allocation/"},{"id":"b-incentive-misalignment","kind":"bottleneck","name":"Incentives reward me-too drugs and marginal gains","route":"/bottlenecks/b-incentive-misalignment/"},{"id":"b-hereditary-risk","kind":"bottleneck","name":"Inherited risk is mostly unidentified","route":"/bottlenecks/b-hereditary-risk/"},{"id":"b-global-access","kind":"bottleneck","name":"Most of the world has almost no cancer care","route":"/bottlenecks/b-global-access/"},{"id":"b-overdiagnosis","kind":"bottleneck","name":"Overdiagnosis and false alarms","route":"/bottlenecks/b-overdiagnosis/"},{"id":"b-prevention-adoption","kind":"bottleneck","name":"Prevention we already have is not deployed","route":"/bottlenecks/b-prevention-adoption/"}],"paper":[{"id":"paper-caret-beta-carotene-retinol-lung-cancer-nejm-1996","kind":"paper","name":"Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease","route":"/key-papers/paper-caret-beta-carotene-retinol-lung-cancer-nejm-1996/"},{"id":"paper-barnabas-nejm-evid","kind":"paper","name":"Efficacy of single-dose HPV vaccination among young African women","route":"/key-papers/paper-barnabas-nejm-evid/"},{"id":"paper-peto-smoking-cessation-lung-cancer-uk-bmj-2000","kind":"paper","name":"Smoking, smoking cessation, and lung cancer in the UK since 1950: combination of national statistics with two case-control studies","route":"/key-papers/paper-peto-smoking-cessation-lung-cancer-uk-bmj-2000/"},{"id":"paper-doll-hill-mortality-of-doctors-smoking-bmj-1954","kind":"paper","name":"The mortality of doctors in relation to their smoking habits; a preliminary report","route":"/key-papers/paper-doll-hill-mortality-of-doctors-smoking-bmj-1954/"},{"id":"paper-wynder-graham-tobacco-bronchiogenic-carcinoma-jama-1950","kind":"paper","name":"Tobacco smoking as a possible etiologic factor in bronchiogenic carcinoma; a study of 684 proved cases","route":"/key-papers/paper-wynder-graham-tobacco-bronchiogenic-carcinoma-jama-1950/"}]}}