Fraumeni noted that the explosive developments in molecular biology are now providing new challenges and opportunities for population-based studies, and that interdisciplinary approaches are likely to broaden and deepen our understanding of cancer etiology and prevention. He discussed the increasingly important role that genetics and molecular biology is playing in the treatment and prevention of cancer, and proposed that the future of cancer genetics lies in identifying the modifiers of inherited predisposition genes. Treatment and prevention are two very different approaches to reducing the cancer burden in today s world, but Klausner believes that in the future the two will converge. Intervention strategies will reflect our growing understanding of the mechanisms through which cancer develops due to accumulated changes in the instructions that guide the behavior of cells. Hidden in those changes are hints to their causes, which, Klausner proposed, will be the keys to a new generation of targeted prevention strategies.
Cancer is a disease of genetic and genomic instability.
The inherited susceptibility syndromes allow us to see signals through that noise. Al Knudson s groundbreaking research, first published in 1971, provides the basis of our current ability to find and identify cancer-causing genes. Knudson is well known for proposing that some critical genes function as tumor suppressors, using data on retinoblastoma, a rare syndrome causing retinal tumors in children. The relative risk of RB1 is high persons carrying the gene are 100,000 times more likely to develop retinoblastoma than those without the gene. The allele frequency of RB1, however, is quite low about one person in 100,000 carries the gene.