Abstract IA001: Innovation and equity in cancer prevention and screening

Abstract

Abstract This presentation will highlight some of the opportunities for improving cancer prevention and screening of asymptomatic individuals, which includes increasing the uptake of current standard of care and research for new interventions that can become standard of care. It is important to strive to address cancer disparities in the US and globally, as the greatest population-wide benefit for current and new interventions will be derived from equitable access to them. To increase the likelihood that uptake of new interventions will be equitable, this parameter should be considered throughout the development and evaluation of the candidate interventions, rather than waiting until after they have been approved. The main goals of prevention and screening are to enable people to live longer healthier lives, and approved interventions should ultimately be held to this standard, although initial approval, especially for primary prevention, may be based on surrogate endpoints. For example, initial HPV vaccine approval, in 2006, was based on its reduction in cervical dysplasia rates. Reduced cancer risk was not observed until more than a decade after that, and the vaccine has still not been formally shown to reduce mortality rates from HPV-associated cancer. The global equitable uptake of the HPV vaccine lags considerably, although the vast majority of HPV-associated cancers occur in low- and middle-income countries. We and others are conducting research to address this important gap. For cancer screening, a much shorter interval is usually needed to determine if the intervention does reduce cancer-specific mortality rates. This parameter is highly relevant for multicancer detection tests, which have considerable potential. While these tests can detect asymptomatic cancer earlier than if one waited for symptoms to develop, it remains to be demonstrated whether cancer detected by this approach will reduce cancer-specific mortality rates. It is also critical to develop equitable approaches for cancer diagnosis and treatment triggered by a positive test. Citation Format: Douglas R. Lowy. Innovation and equity in cancer prevention and screening. [abstract]. In: Proceedings of the AACR Special Conference: Precision Prevention, Early Detection, and Interception of Cancer; 2022 Nov 17-19; Austin, TX. Philadelphia (PA): AACR; Can Prev Res 2023;16(1 Suppl): Abstract nr IA001.