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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.
Remove the at-risk tissue or block the hormonal/inflammatory driver of carcinogenesis.
Acitretin is a vitamin A tablet licensed for severe psoriasis. In people who have had an organ transplant and keep developing skin cancers, it reduces the number of new squamous cell carcinomas while it is taken.
Imiquimod (Aldara) is a cream that provokes the skin's own immune system to clear superficial basal cell carcinomas and the sun-damage patches (actinic keratoses) that can turn into skin cancer.
Nicotinamide is a cheap over-the-counter form of vitamin B3. Taken twice a day it cuts the number of new skin cancers in people who have already had several, by helping skin cells repair sun damage.
Raloxifene (Evista) is an osteoporosis tablet that also lowers the chance of developing invasive breast cancer in postmenopausal women at higher risk, with fewer womb-cancer problems than tamoxifen.
The original targeted cancer drug (1977): a pill that blocks oestrogen's effect on breast cancer and halves recurrence, still essential for premenopausal women.
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.
Targeted visual screening of tobacco and alcohol users is a cheap, workable way to cut oral cancer deaths in high-incidence countries, and is the basis for India's national oral cancer screening component. Its effect depends on people attending repeatedly and on treatment being available.
Query 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.
Shares GLP-1 drugs to reverse endometrial precancer in women with obesity, VITAL (VITamin D and OmegA-3 TriaL), A trial of GLP-1 weight-loss drugs with cancer as the primary outcome, Vitamin D and omega-3 supplementation.
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, Prevention we already have is not deployed.
Shares Nouscom, Cancer interception vaccines for high-risk carriers, Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers, Inherited risk is mostly unidentified.
Shares GLP-1 drugs to reverse endometrial precancer in women with obesity, Regulators accept shrinking of precancer as the endpoint for prevention drug approval, Low-dose tamoxifen for high-risk women, prescribed by pharmacists and nurses, One master trial for cancer prevention drugs across many precancers.
Shares Risk factor, Bariatric surgery and cancer incidence, GLP-1 receptor agonists and obesity-related cancer risk, Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers.
Shares Sun protection after a skin cancer diagnosis, Skin cancer after an organ transplant, Field cancerisation, Cutaneous squamous cell carcinoma.
Shares Systematic drug repurposing, Aspirin for cancer prevention and adjuvant therapy, Microenvironment and inflammation: tumours as wounds that do not heal, Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers.
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, Gastric & gastro-oesophageal junction cancer.