Predictive value of human genotoxicological biomarkers in the primary prevention of chronic non-infectious diseases

Abstract

The main goal of biomarker research in the frame of primary prevention of chronic diseases is the prevention of appearance of clinical symptoms by an early recognition of the process leading to the symptoms. By the use of well-established biomarkers one can detect such tendencies finally leading to the manifestation of the disease far before the progress turns irreversible. As several parameters play role in such processes, the estimation of biological changes with the help of biomarkers is a precise and relatively simple means of the prevention. Indications of intervention in order to prevent the manifestation of a disease are rather determined by the nature but not the number of alterations. The use of genetic screening and monitoring by adequate biomarkers provide us with a new opportunity to measure such qualitative changes rather than the quantitative ones, ensuring a great improvement to the previous methods. The use of qualitative parameters as a routine method instead of the classic quantitative measures might represent a challenge for current prevention policies in Europe to approach health problems and safety at work. When the biomarkers give positive results that means a high probability to be at risk but not yet the manifestation of a certain illness. This stage may be relevant to the early onset of certain pathological processes, but it does not necessarily turn to a performed disease. In consequence a so-called positive result might cause unnecessary disturbances for the probands leading to ethical issues of risk communication. The monitoring system, however, should find acceptable communication strategies for the high-risk conditions detected by the well-established biomarkers.