Despite great advances in our understanding of cancer at the cellular and molecular level there has been little improvement in our ability to establish cancer causation. Our greatest successes in fighting cancer derive from the identification and removal or inactivation of carcinogenic substances, and from the identification and removal of pre-malignant lesions. Therefore, understanding cancer causation and cancer prevention should be emphasized. In the recent past, several chemical and infectious agents have been linked to tumor development. This has led to the implementation of preventive and therapeutic measures that have had a tremendous impact in decreasing cancer incidence (e.g., β-anylin removal and bladder carcinoma; HBV vaccination and hepatocellular carcinoma). It is clear that the ideal intervention is to prevent cancer from developing at all. Infectious agents, chemical substances, and physical factors have all been associated with disease and cancer causation. For acute diseases associated with microorganisms, the association and causative relationships are usually readily established. Koch’s postulates  provided a framework for pinpointing the associated bacterium with the specific illness it caused. In situations where such clarity cannot be obtained experimentally, epidemiologists have used the Hill’s criteria established in 1965  to link various diseases with extrinsic causative
Seminars in Cancer Biology – Elsevier
Published: Dec 1, 2004
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