Additionally, the researchers are evaluating tobacco screening approaches, use of the tobacco cessation programs, costs for patients, and tobacco cessation outcomes in cancer patients. HPV vaccines, co-invented by NCI researchers, have been proven safe and effective and have been in use since Despite the availability of the vaccines, uptake in the United States and elsewhere is far lower than ideal.

Through the NCI Costa Rica HPV Vaccine Trial , conducted in , NCI and Costa Rican researchers discovered that a single vaccine dose might provide adequate protection. Wide-spread use of a single-dose HPV vaccine schedule would help dramatically increase HPV vaccination globally.

NCI and Costa Rican investigators launched the ESCUDDO study to determine the protection afforded by a single dose of the HPV vaccines, compared with the recommended multiple doses, in young girls.

Findings from the trial will provide the definitive evidence about whether or not a single dose is as good as two doses of vaccine. Results from the trial are intended to provide actionable evidence needed to update current HPV vaccine recommendations in the United States and globally.

There are several challenges to cervical cancer control worldwide that differ in high- and low-resource settings. Areas with ample resources still face issues of inefficient screening, overtreatment, and low HPV vaccine uptake in some places.

In contrast, in areas with limited resources, multi-visit screening programs are unsustainable for many reasons. In addition, people in these areas struggle with lack of access to screening tests, limited treatment options, and lack of access to HPV vaccines. To overcome these barriers, NCI researchers are addressing four major areas:.

Learn more about these efforts. ACCSIS is improving colorectal cancer screening, follow-up, and referral for care among populations that have low colorectal cancer screening rates.

ACCSIS will focus on underserved groups in particular, including racial and ethnic minority populations and people living in rural or difficult-to-reach areas. The two-phase projects in this program are designing multilevel interventions to reduce the burden of colorectal cancer.

The first phase of these projects focuses on pilot studies that demonstrate the feasibility and potential effectiveness of multilevel interventions for increasing colorectal cancer screening and follow-up. The second phase involves testing the implementation and impact of the multilevel interventions in target populations with low colorectal cancer screening rates.

The ACCSIS Coordinating Center provides, collects, and shares resources with ACCSIS centers and the broader research community, and contributes to the evaluation of approaches to increase CRC screening. More information about this program can be found at the ACCSIS website. With routine screening, you can detect cancer early before signs or symptoms appear!

Early detection of cancer can mean less extensive treatment, more treatment options and better chances of survival. The best way to detect cancer early and increase your chances for Better Outcomes is to get the routine cancer screenings and checkups recommended for you.

Routine vaccinations and tests are also available for certain viruses that can cause cancer. Learn more about viruses linked to cancer. Discover the cancer screenings you need today. Here, we are not dealing with a mathematical or technical problem; the implementation of risk-adapted breast cancer prevention and screening strategies does not constitute a simple change that has a simple solution, but rather necessitates complex adaptive changes that require all stakeholders, scientists, health-care professionals, the lay public and policymakers to work together.

The schematic illustrates the various multilevel interactions between the different components needed for the implementation of risk-stratified programmes for the early detection and prevention of cancer.

The ultimate goal is an improvement in population health outcomes. To achieve this goal, the process has to be iterative within a learning health-care system. Organizational readiness for systems change is widely recognized as being necessary for the successful implementation of complex changes in health-care settings This state reflects the extent to which those involved in implementing the new approach are primed, motivated and capable of achieving the required changes Organizational readiness is a dynamic process with pull and push factors between what is possible owing to constant emergence of new technological opportunities and what resources are available To address the challenge of a constantly changing environment, health-care organizations should embrace an evolutionary approach, rather than espouse a sudden dramatic shift, by adopting a learning organizational culture and building on existing infrastructure In keeping with this concept, the adaptive design of WISDOM enables learning and adaptation of the risk-assessment model and the screening recommendations accordingly over the course of the trial, instead of waiting for certain new discoveries to emerge before starting the trial, or excluding participants of non-European ancestry for whom limited relevant data are currently available CED provides a mechanism for promising but unproven health technologies to enter practice sooner, through time-limited reimbursement that is conditional on a specific requirement for generation of further evidence on the performance of the new technology.

Readiness for change requires the commitment and engagement of all stakeholders, resources including knowledge, skills, time, money and infrastructure and governance To ensure the commitment of health-care organizations, the need for a change should be recognized and embedded in a shared vision, with leadership and coalition of all stakeholders , To achieve a shared vision, the stakeholders have to agree on a framework of values that are aligned with those of the health-care organization.

For example, health-care organizations value time-efficiency; therefore, successful implementation would require time-respecting strategies and tools, such as having one test to predict multiple cancers which is a goal that FORECEE 32 aims to achieve.

Overall, vision, skills, incentives, resources and action plans are needed to achieve the systems change that will be required for implementation of risk-stratified prevention and early detection programmes for breast cancer Given the diverse opinions on breast cancer screening among key stakeholders at present and the specific challenges of risk-stratified screening, engagement of all stakeholders is crucial to implementation of new programmes.

A stakeholder is a person, group or organization involved in or affected by a decision Key stakeholders in breast cancer prevention and screening include the users and the providers of the service, health-care professionals, policymakers, payers, advocacy groups, researchers and others.

Stakeholder engagement would enable the identification of potential misunderstandings among the various stakeholders regarding opposition to, and perspectives on, the implementation of a risk-stratified programme Using a multistakeholder approach to reach agreement on what would constitute sufficient evidence to change practice and on guidelines would increase the chances of implementing the research findings within the health-care system Such an approach would also help to articulate the values and preferences of the wider community and to build mutual trust, thereby facilitating the implementation of a programme that is accessible and acceptable.

Stakeholder analysis would be useful to not only identify the key stakeholders, but also their interests and influences, and the level of involvement of each whether it be provision of information, consultation, deliberation, participatory decision-making or delegated decisions This attitude is attributable to suboptimal levels of risk literacy among both patients and doctors as well as the limited transparency in the reporting of risks in the media and patient brochures Importantly, therefore, women should be transparently informed — for example, using fact boxes , — about their baseline risks and the benefit to harm ratio of risk-based screening as compared to the existing options of a universal screening approach or no screening The development of risk-stratified programmes will need to include consideration of how to update risk assessments as risk-prediction models improve and how to communicate these changes to individuals.

Communicating information on breast cancer risk alone is unlikely to result in changes in health-related behaviours, such as smoking or low levels of physical activity , , Indeed, a methodical review of nine systematic reviews, encompassing at total of 36 unique studies, revealed no evidence that providing risk information would have strong, consistent or sustained effects on behaviour Changes in health-related behaviour can, however, be facilitated by including elements of interventions to alter the behaviour in question Importantly, the available evidence suggests that providing women with their breast cancer risk estimates is unlikely to produce elevated distress Nevertheless, knowledge of whether providing risk estimates will promote informed choices regarding screening attendance is lacking, although the evidence base is starting to increase More definitive conclusions regarding the behavioural and emotional effects of receiving risk estimates require studies specifically designed to assess these questions for example, PROCAS2 ref.

Acceptability is a complex and poorly defined concept The level of uptake is one index of the acceptability of a risk assessment. Many studies have addressed the issue of acceptability of risk-stratified screening for breast cancer from the perspective of women 38 , and of health-care professionals and policymakers The available evidence suggests that risk-stratified screening is broadly acceptable to women if it involves the potential for more frequent screening for those deemed to be at high risk , By contrast, a number of concerns exist among professionals working in this area, not least regarding costs and the available evidence base Similarly, major reservations surrounding the appropriateness of reducing the frequency of screening for women deemed to be at low risk have been expressed by health-care professionals, policymakers and women themselves A few high-quality ongoing studies 36 , 37 are examining these issues empirically, rather than discussing the issues as hypothetical possibilities Effective delivery of risk-stratified prevention and screening services requires health-care professionals to be competent in the use of a risk tool, in interpreting and applying the risk scores and in communicating risk scores effectively to each individual, including discussion of the accuracy of the risk prediction and its future implications Risk-stratified approaches entail epi genetic testing for risk assessment.

Health-care professionals need not become geneticists to effectively use the epi genomic information obtained ; however, they need to be sufficiently versed in epi genomics — for example, in understanding the contribution of common and rare coding variants to risk prediction, gene-panel testing and DNA-sequencing modalities and the implications of identifying pathogenic variants with poorly defined cancer risks or genetic variants of uncertain significance VUS Health-care systems should develop clear guidance related to the reporting of VUS in order to aid health-care professionals in the management of these variants, including descriptions of how patients with VUS should be informed if and when variants are found to confer an additional risk.

Accordingly, aspects of genomics and risk-stratified interventions should be integrated across the continuum of training for health-care professionals, from undergraduate education to broad specialty training to continuous professional development programmes. Educational-needs assessments should inform the educational requirements of each medical specialty Ethical, legal and social issues need to be considered at every step of implementation of risk-based interventions, from health-service planning, invitation of participants and consent and sample collection, to risk calculation, communication of results and storage of data , Some of the issues associated with risk-stratified screening will be dependent on the methods by which a programme is implemented The four principles of bio-ethics promulgated by Beauchamp and Childress — autonomy, beneficence, non-maleficence and justice — provide a useful framework to understand the potential implications of risk-based screening, although these principles are more commonly applied to the doctor—patient relationship in the clinical context.

Respecting autonomy requires that an individual has adequate knowledge and understanding to decide whether they wish to opt for a given intervention.

The capacity of the individual to independently make an informed decision will depend on the information content, the communication tools used and the adequacy of workforce training in conveying the relevant information.

Optimizing the balance between providing benefit beneficence and the potential for harm maleficence with a risk-based screening programme requires rigorous evaluation.

This balance also requires consideration and mitigation of potential unintended harms of such programmes. These unintended harms might include the negative consequences of risk assessment for individuals such as anxiety and breaches of confidential genetic and other personal data or at a society level stigmatization of and discrimination against some individuals because of their risk level and non-participation of some individuals in the programme, for example, because they perceive that health care is being rationed for those for whom less screening is recommended Finally, justice relates to the fairness of a programme.

Screening programmes have the potential to increase health inequalities, owing to differences in the level of uptake between socioeconomic groups, including those covered under universal health systems , , Risk-based screening programmes might exacerbate these differences , given their additional complexity and inherent selectivity relative to universal screening.

Communication relating to screening and risk assessment has to be accessible and congruent to the literacy and numeracy level of the recipients while also accurately presenting both the potential benefits and risks Meeting these requirements will not only avoid misinterpretation of the information provided and subsequent inequitable use of screening services, but also enable each individual to make an informed decision In addition, robust legislation is necessary to prevent discrimination and stigmatization, in particular, by insurers and employers.

Current approaches vary by country, but can be broadly divided into four categories: moratoria, industry self-regulation, legal limitations to the use of genetic information, and legal bans , As an example, in the UK, an open-ended code of practice between insurers and the government exists, prohibiting the use of predictive genetic tests except in defined circumstances The time is right to perform implementation research in a real-world setting of risk-stratified prevention and screening for breast cancer, with clearly defined criteria for success for example, relating to the extent of adoption, appropriateness, acceptability, sustainability, cost implications and effectiveness of the programme.

The research should be designed and conducted together with all stakeholder groups, taking into account the ethical, legal and social context as well as factors that affect implementation such as the idiosyncrasies of the health-care system and organizational readiness.

The process has to be iterative in a health-care system conducive to learning and adaptation To reduce the time lag between obtaining evidence on the effectiveness of a programme and its implementation, studies with hybrid effectiveness—implementation design could be used Box 2.

Several strategies adopted in WISDOM, such as the adaptive design, multistakeholder approach and CED model , will accelerate implementation of the findings. A third type of hybrid design involves the simultaneous study of effectiveness and implementation strategies. This approach enables the demonstration of which implementation strategies work in a given context, as opposed to demonstrating the effects of a particular implementation strategy on the adoption or uptake of an intervention This approach would require linking of genetic profiles and the outcomes of preventive interventions to cancer registries, training of treating physicians to develop a working knowledge of cancer risk and genetics, and the development of decision aids for patients.

In this group, the intervention might not only substantially improve clinical management, but also provide valuable information on how risk-stratified programmes might perform in the general population. Thus, the results of this pilot approach could form the basis on which to build subsequent population-level risk-based interventions.

Bray, F. et al. Global cancer statistics GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in countries. CA Cancer J. Article PubMed Google Scholar.

Sørlie, T. Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Natl Acad. USA 98 , — PubMed PubMed Central Google Scholar.

Blows, F. Subtyping of breast cancer by immunohistochemistry to investigate a relationship between subtype and short and long term survival: a collaborative analysis of data for 10, cases from 12 studies.

PLoS Med. Curtis, C. The genomic and transcriptomic architecture of 2, breast tumours reveals novel subgroups. Nature , — CAS PubMed PubMed Central Google Scholar.

Yang, X. Associations of breast cancer risk factors with tumor subtypes: a pooled analysis from the Breast Cancer Association Consortium studies. Natl Cancer Inst. PubMed Google Scholar.

Broeks, A. Low penetrance breast cancer susceptibility loci are associated with specific breast tumor subtypes: findings from the Breast Cancer Association Consortium.

Turkoz, F. Association between common risk factors and molecular subtypes in breast cancer patients. Breast 22 , — Waks, A. Breast cancer treatment: a review. JAMA , — CAS PubMed Google Scholar.

Cancer Research UK. Netherlands Cancer Registry. Nelson, H. Risk factors for breast cancer for women aged 40 to 49 years: a systematic review and meta-analysis. Brinton, L. in Cancer Epidemiology Prevention eds Thun, M. Winters, S. Breast cancer epidemiology, prevention and screening.

Transl Sci. Hartmann, L. Benign breast disease and the risk of breast cancer. Moorthie, S. Personalised Prevention in Breast Cancer: the Policy Landscape University of Cambridge, Familial Breast Cancer: Classification, Care and Managing Breast Cancer and Related Risks in People with A Family History of Breast Cancer NICE, Owens, D.

Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer. JAMA , Alexander, F. Lancet , — Habbema, J. Age-specific reduction in breast cancer mortality by screening: an analysis of the results of the Health Insurance Plan of Greater New York study.

Nystrom, L. Long-term effects of mammography screening: updated overview of the Swedish randomised trials. Miller, A. The Canadian National Breast Screening Study breast cancer mortality after 11 to 16 years of follow-up.

A randomized screening trial of mammography in women age 40 to 49 years. Moss, S. Welch, H. Breast-cancer tumor size, overdiagnosis, and mammography screening effectiveness. Drukker, C. Mammographic screening detects low-risk tumor biology breast cancers.

Breast Cancer Res. Esserman, L. Rethinking screening for breast cancer and prostate cancer. Pashayan, N.

Cost-effectiveness and benefit-to-harm ratio of risk-stratified screening for breast cancer a life-table model. JAMA Oncol. Google Scholar.

Trentham-Dietz, A. Tailoring breast cancer screening intervals by breast density and risk for women aged 50 years or older: collaborative modeling of screening outcomes.

Burton, H. Public health implications from COGS and potential for risk stratification and screening. Horizon European Research Council. Prevent Breast Cancer. PROCAS 2. Rainey, L. Are we ready for the challenge of implementing risk-based breast cancer screening and primary prevention? Breast 39 , 24—32 The Health Foundation.

Evidence Scan: Complex Adaptive Systems The Health Foundation, Michailidou, K. Association analysis identifies 65 new breast cancer risk loci. Nature , 92—94 Milne, R. Identification of ten variants associated with risk of estrogen-receptor-negative breast cancer.

Easton, D. Gene-panel sequencing and the prediction of breast-cancer risk. Rudolph, A. Joint associations of a polygenic risk score and environmental risk factors for breast cancer in the Breast Cancer Association Consortium.

Mavaddat, N. Polygenic risk scores for prediction of breast cancer and breast cancer subtypes. Lee, A. BOADICEA: a comprehensive breast cancer risk prediction model incorporating genetic and nongenetic risk factors.

Läll, K. Polygenic prediction of breast cancer: comparison of genetic predictors and implications for risk stratification. BMC Cancer 19 , Choudhury, P.

Comparative validation of breast cancer risk prediction models and projections for future risk stratification. LaDuca, H. A clinical guide to hereditary cancer panel testing: evaluation of gene-specific cancer associations and sensitivity of genetic testing criteria in a cohort of , high-risk patients.

Schmidt, M. Foulkes, W. Estrogen receptor status in BRCA1- and BRCA2-related breast cancer. Cancer Res. Fletcher, O. Missense variants in ATM in 26, breast cancer cases and 29, controls.

Cancer Epidemiol. Biomarkers Prev. Gao, P. Functional variants in NBS1 and cancer risk: evidence from a meta-analysis of 60 publications with individual studies. Mutagenesis 28 , — Weitzel, J. Pathogenic and likely pathogenic variants in PALB2, CHEK2, and other known breast cancer susceptibility genes among BRCA negative Hispanics with breast cancer.

Cancer , — Parsons, M. Large scale multifactorial likelihood quantitative analysis of BRCA1 and BRCA2 variants: an ENIGMA resource to support clinical variant classification. Kleiblova, P.

Identification of deleterious germline CHEK2 mutations and their association with breast and ovarian cancer. Cancer , ijc. Boonen, R. Functional analysis of genetic variants in the high-risk breast cancer susceptibility gene PALB2. Lee, K. Clinical validity assessment of genes frequently tested on hereditary breast and ovarian cancer susceptibility sequencing panels.

Teschendorff, A. DNA methylation outliers in normal breast tissue identify field defects that are enriched in cancer. Curtius, K. An evolutionary perspective on field cancerization. Cancer 18 , 19—32 Yang, Y. Genetically predicted levels of DNA methylation biomarkers and breast cancer risk: data from , women of European descent.

Xu, Z. Blood DNA methylation and breast cancer: a prospective case-cohort analysis in the Sister study. Age-dependent DNA methylation of genes that are suppressed in stem cells is a hallmark of cancer. Genome Res. Knower, K. Endocrine disruption of the epigenome: a breast cancer link.

Cancer 21 , T33—T55 Levine, M. Menopause accelerates biological aging. USA , — Widschwendter, M. Epigenome-based cancer risk prediction: rationale, opportunities and challenges. Bodelon, C. Blood DNA methylation and breast cancer risk: a meta-analysis of four prospective cohort studies.

An epigenetic signature in peripheral blood predicts active ovarian cancer. PLoS One 4 , e Key, T. Sex hormones and risk of breast cancer in premenopausal women: a collaborative reanalysis of individual participant data from seven prospective studies.

Lancet Oncol. Body mass index, serum sex hormones, and breast cancer risk in postmenopausal women. Fourkala, E. Association of serum sex steroid receptor bioactivity and sex steroid hormones with breast cancer risk in postmenopausal women. Cancer 19 , — Bau, D.

DNA double-strand break repair capacity and risk of breast cancer. Carcinogenesis 28 , — Machella, N. Double-strand breaks repair in lymphoblastoid cell lines from sisters discordant for breast cancer from the New York site of the BCFR.

Carcinogenesis 29 , — Gail, M. Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. Tice, J. Using clinical factors and mammographic breast density to estimate breast cancer risk: development and validation of a new predictive model.

Garcia-Closas, M. Combined associations of genetic and environmental risk factors: implications for prevention of breast cancer.

Maas, P. Breast cancer risk from modifiable and nonmodifiable risk factors among white women in the United States. Chatterjee, N.

Developing and evaluating polygenic risk prediction models for stratified disease prevention. Tyrer, J. A breast cancer prediction model incorporating familial and personal risk factors.

Antoniou, A. The BOADICEA model of genetic susceptibility to breast and ovarian cancers: updates and extensions. Cancer 98 , — Zimmern, R.

The evaluation of genetic tests. University of Cambridge. Centre for Cancer Genetic Epidemiology. Louro, J. A systematic review and quality assessment of individualised breast cancer risk prediction models. Cancer , 76—85 Terry, M. iCARE: An R package to build, validate and apply absolute risk models.

PLoS One 5 , e Smart, A. A multi-dimensional model of clinical utility. Health Care 18 , — Sanderson, S. How can the evaluation of genetic tests be enhanced?

Lessons learned from the ACCE framework and evaluating genetic tests in the United Kingdom. Grosse, S. What is the clinical utility of genetic testing? pdf Wainschtein, P. Recovery of trait heritability from whole genome sequence data. Article Google Scholar.

Yala, A. A deep learning mammography-based model for improved breast cancer risk prediction. Radiology , 60—66 Arasu, V. Population-based assessment of the association between magnetic resonance imaging background parenchymal enhancement and future primary breast cancer risk.

Malkov, S. Mammographic texture and risk of breast cancer by tumor type and estrogen receptor status. Gastounioti, A. Beyond breast density: a review on the advancing role of parenchymal texture analysis in breast cancer risk assessment.

Wang, C. A novel and fully automated mammographic texture analysis for risk prediction: results from two case-control studies.

Nguyen, T. Predicting interval and screen-detected breast cancers from mammographic density defined by different brightness thresholds. Cohen, J. Detection and localization of surgically resectable cancers with a multi-analyte blood test.

Science , — Wan, J. Liquid biopsies come of age: towards implementation of circulating tumour DNA. Cancer 17 , — Best, M. RNA-Seq of tumor-educated platelets enables blood-based pan-cancer, multiclass, and molecular pathway cancer diagnostics.

Cancer Cell 28 , — Eddy, D. Model transparency and validation: a report of the ISPOR-SMDM modeling good research practices task force — 7. Value Health 15 , — Dagenais, G. Variations in common diseases, hospital admissions, and deaths in middle-aged adults in 21 countries from five continents PURE : a prospective cohort study.

Fulcher, J. Efficacy and safety of LDL-lowering therapy among men and women: meta-analysis of individual data from participants in 27 randomised trials. Collaborative Group on Hormonal Factors in Breast Cancer. Type and timing of menopausal hormone therapy and breast cancer risk: individual participant meta-analysis of the worldwide epidemiological evidence.

PubMed Central Google Scholar. Hamajima, N. Alcohol, tobacco and breast cancer — collaborative reanalysis of individual data from 53 epidemiological studies, including 58, women with breast cancer and 95, women without the disease.

Cancer 87 , — Bagnardi, V. Alcohol consumption and site-specific cancer risk: a comprehensive dose—response meta-analysis. Renehan, A. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies.

Cuzick, J. Progress in preventive therapy for cancer: a reminiscence and personal viewpoint. Fisher, B. Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. Aromatase inhibitors for breast cancer prevention.

Anastrozole for prevention of breast cancer in high-risk postmenopausal women IBIS-II : an international, double-blind, randomised placebo-controlled trial. Goss, P. Exemestane for breast-cancer prevention in postmenopausal women.

First results from the International Breast Cancer Intervention Study IBIS-I : a randomised prevention trial. Overview of the main outcomes in breast-cancer prevention trials. Powles, T. Interim analysis of the incidence of breast cancer in the Royal Marsden Hospital tamoxifen randomised chemoprevention trial.

Lancet , 98— Veronesi, U. Prevention of breast cancer with tamoxifen: preliminary findings from the Italian randomised trial among hysterectomised women.

Lancet , 93—97 Twenty-year follow-up of the Royal Marsden randomized, double-blinded tamoxifen breast cancer prevention trial. Tamoxifen for prevention of breast cancer: extended long-term follow-up of the IBIS-I breast cancer prevention trial.

Vogel, V. Effects of tamoxifen vs raloxifene on the risk of developing invasive breast cancer and other disease outcomes: the NSABP study of tamoxifen and raloxifene STAR P-2 trial. Update of the National Surgical Adjuvant Breast and Bowel Project Study of Tamoxifen and Raloxifene STAR P-2 Trial: preventing breast cancer.

Cancer Prev. CAS Google Scholar. Use of medications to reduce risk for primary breast cancer: a systematic review for the U. Preventive Services Task Force. Medication use to reduce risk of breast cancer: US Preventive Services Task Force recommendation statement. Armstrong, N.

Discover Screenings You Need Find a Doctor. Routine screenings and checks are available for:. Breast Cancer Colorectal Cancer Oral Cancer Skin Cancer.

Cervical Cancer Lung Cancer Prostate Cancer Testicular Cancer. Need a doctor? Zocdoc helps you find and book top-rated doctors, on demand. Visit them in their offices, or video chat with them from home. Check out doctors in your area. Thank you to our generous sponsors.

Sign up to get the latest about cancer prevention and early detection directly in your inbox. This section is designed to be a source of basic information about cancer prevention and early detection, and its intended audience is the diverse American public. We seek to use language that is inclusive of all and avoid unnecessary expressions of sex or gender.

However, text that is based on research findings which specify gender, for example, uses the language dictated by the research. The information, including but not limited to, text, graphics, images and other material contained on this website are intended to increase awareness and provide information.

No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Prevention and Early Detection Learn More. Breast Cancer Cervical Cancer Colorectal Cancer Liver Cancer Lung Cancer Oral Cancer Prostate Cancer Skin Cancer Testicular Cancer.

Prevention and Early Detection Cancer touches almost everyone. Download A Guide to Preventing Cancer Take Screening Quiz. Ways to Prevent Cancer Learn More. Cancer Prevention and Screening Learn More.

Know Your Family History Learn More. Free and Low-Cost Cancer Screenings Learn More. Viruses and Cancer Learn More. Download Resources LEARN MORE. RECURSOS EN ESPAÑOL aprende más. Preventable Cancers. Breast Cancer.