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The development of cancer is a slow process and it very often takes
a number of years before a tumor becomes clinically evident. No
current te- nique is sensitive and specific enough to detect tumors
at their earliest stage, i. e. , when the tumor is smaller than one
billion cells. Consequently, the d- ease is usually diagnosed in an
advanced state, very often when it is already beyond the reach of
therapeutic strategies. This is the main stumbling block to the
secondary prevention that would reduce cancer mortality. There is
hope, however, because in the last decade we have witnessed an
explosion of reports dealing with tumor markers. In many instances,
simple, noninvasive diagnostic tests are becoming available to
detect the early signs ofneoplasia. Interest in early detection of
neoplasia is growing among those basic scientists, cli- cians, and
health professionals who realize that progress in reducing cancer
mortality is dependent to a great degree on its early detection and
prevention. Some disappointment usually accompanies these
discoveries, because what at first glance proves to be promising,
is in many instances, applicable only to a limited number of cases.
What is the cause of these failures? The answer may be that cancer
is a multitude of neoplastic diseases in which endogenous and
exogenous etiologic factors contribute either sim- taneously or
over a lifetime to the development of disease.
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