Cancer prevention in the year 2025: an anticipation.

European Journal of Cancer 36 (2000) 1737±1740 www.ejconline.com Point of View Cancer prevention in the year 2025: an anticipation F.L. Meyskens Jr * Chao Family Comprehensive Cancer Center, University of California, Irvine, 101 The City Drive, RT. 81, Bldg 23, Room 406, Orange, CA 92868-3298, USA Received 13 April 2000; accepted 13 April 2000 It is said that only fools make predictions, so let us call my ramblings `anticipations'. In the year 2025 the last of the traditional inpatient hospitals closed. Could such an event come to pass? What assumptions need we make? What could possibly happen that would make this event, not just possible, but inevitable? One way to explore the anticipation for 2025 is to look at the reality of 1975. In 1975 there were no microwave ovens or automatic coee makers. In 1975 there were no fax machines, Xerox copiers, video conferencing, personal computers, the internet or e-mail. In 1975 there were no automated telling machines (ATMs), personal global positioning devices, pagers, laser pointers, liquid crystal display (LCD) projectors, mobile phones, compact discs, digital watches or cam- eras, or Palm Pilots. In 1975 there were no pipettemens, Northern or Western blots, phosphorimagers, ESTs, polymerase chain reaction (PCR) or gene blasts; no automated DNA sequencing and no kits (of any kind). In 1975 oncogenes were just surfacing. There were no tumour suppressor genes (at least we didn't think of them that way), no gene cloning and no Dolly. In 1975 there was no ®lgrastim (Neupogen) or epoetin alpha (Epogen) or serotonin inhibitors. No interferon or paclitaxel (Taxol) trastuzumab (Herceptin) and so on. In 1975, computer tomography (CT) scans were prim- itive. There were no magnetic resonance imagers (MRIs) or positron emission tomography (PETs). First presented as the Presidential Address at the 1st Interna- tional Conference on Tumor Prevention and Genetics (2000) and the 5th Annual Meeting of the International Society of Cancer Chemo- prevention, 17±19 February 2000, St Gallen, Switzerland. * Tel.: +1-714-456-6310; fax: +1-714-456-2240. E-mail address: ¯meyske@uci.edu (F.L. Meyskens Jr). In 1975 ®breoptic endoscopy had not been developed and prostate speci®c antigen (PSA) was undiscovered. We also still debated whether screening mammography gave you more or fewer breast cancers. Since 1975 all levels of modern society have been transformed: easier, faster, better, and . . . unexpected. In the year 2025 who really knows what the world will be like. In the words of one colleague in commenting about 1975, ``It's hard to think of things that are still in use.'' I agree, and with the accelerated pace of discovery in all the sciences, predictions are hard to make, but I think anticipations, however fanciful sounding today, are reasonable. The major advances of society and civilisation as a whole in the 20th century were driven by discoveries in physics and chemistry and the selection of Einstein by Time as the Man of the Century re¯ects that reality. In the 21st century, civilisation and society will be transformed by advances in the biomedical sciences brokered by the power of technological advances in computers and information analysis and implementation. So what are some of the `big' assumptions that we need to make to anticipate the reality of 2025? First, the world must remain at peace. Hopefully, the issue of the economic dichotomy of the rich (and richer) and the poor (and poorer) will be addressed, perhaps using the power of technology to narrow the gap. If not, there will be widespread civil wars or more prisons everywhere. Second, the public will insist, more than ever as our population ages, that resources be put into keeping John Q. Citizen healthy, rather than in treating his or her disease. The public really is not interested in getting sick and having their diseases treated. This seems obvious, but there is a basic con¯ict between what many in the medical profession see as important (e.g. more intensive care units (ICUs)) and what the public sees as valuable (more alternative medicine). 0959-8049/00/$ - see front matter # 2000 Elsevier Science Ltd. All rights reserved. PII: S0959-8049(00)00166-0