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**5** 

*USA* 

**Targeting Molecular Pathways for Prevention** 

*Department of Surgery and the Rena Rowan Breast Center, Abramson Cancer Center,* 

Vaccine therapy is traditionally designed to be given prophylactically in order to prevent infectious diseases. Vaccines formulated against pathogens known to cause disease have been successfully created and implementation policies have been effective in the prevention and eradication of many life-threatening diseases. A well-know example of the success that is possible with a well constructed vaccine and an efficient vaccination strategy is the poliomyelitis vaccine. Poliomyelitis was first documented in the late 19th century and it quickly reached the level of causing annual global endemics. The vaccine was introduced in the United States in 1955 and was associated with an immediate reduction in the disease and eventual the elimination of wild-type polioviruses in the United States by 1972. Subsequent global expansion of polio vaccination has resulted in a drastic reduction of documented

A natural next step after the development of prophylactic vaccines to prevent infectious disease was the emergence of vaccines used against specific infectious agents that are known to cause cancer. An estimated 12% of human cancers are attributable to viral infections [2]. Viral infections that are known to cause cancer include human papillomavirus (HPV), hepatitis B virus (HBV), hepatitis C virus (HCV), Epstein-Barr virus (EBV), and Kaposi's sarcoma-associated herpes virus (KSHV). Safe and effective vaccines have been developed against two oncovirus, HPV to prevent HPV-associated cervical carcinoma and

A small number of cancers are directly associated with exposure to an oncovirus. Vaccinating against these viruses and preventing infection and subsequent cancer formation is referred to as 'primary cancer prevention'. This term also encompasses the theoretic potential of vaccinating against non-infectious cancers prior to tumorigenesis. Most cancers do not have a direct link to one specific pathogen. Therefore, experimental cancer vaccines

**1.1 Role of vaccines in disease prevention and cancer prevention** 

cases of the disease as well as eradication of wild type 2 poliovirus [1].

HBV to prevent HBV-associated hepatocellular carcinoma.

**1.2 Primary versus secondary prevention**

**1. Introduction**

*Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA,* 

**of High Risk Breast Cancer:** 

Shayna Showalter and Brian J. Czerniecki

**A Model for Cancer Prevention** 

