Carcinogenesis is the process in which normal cells turn into cancer cells.

Carcinogenesis is the series of steps that take place as a normal cell becomes a cancer cell. Cells are the smallest units of the body and they make up the body's tissues. Each cell contains genes that guide the way the body grows, develops, and repairs itself. There are many genes that control whether a cell lives or dies, divides (multiplies), or takes on special functions, such as becoming a nerve cell or a muscle cell.

Changes (mutations) in genes occur during carcinogenesis.

Changes (mutations) in genes can cause normal controls in cells to break down. When this happens, cells do not die when they should and new cells are produced when the body does not need them. The buildup of extra cells may cause a mass (tumor) to form.

Tumors can be benign or malignant (cancerous). Malignant tumor cells invade nearby tissues and spread to other parts of the body. Benign tumor cells do not invade nearby tissues or spread.

Factors that are known to increase the risk of cancer

Factors that may affect the risk of cancer

Chemoprevention is being studied in people who have a high risk of developing cancer.

Chemoprevention is the use of substances to lower the risk of cancer, or keep it from recurring. The substances may be natural or made in the laboratory. Some chemopreventive agents are tested in people who are at high risk for a certain type of cancer. The risk may be because of a precancerous condition, family history, or lifestyle factors.

Taking one of the following agents may lower the risk of cancer:

• Selective estrogen receptor modulators (SERMS) such as tamoxifen or raloxifene have been shown to reduce the risk of breast cancer in women at high risk. SERMS may cause side effects, such as hot flashes, so they are not often used for prevention of cancer. For more information, see Breast Cancer Prevention.
• Finasteride has been shown to lower the risk of prostate cancer. For more information, see Prostate Cancer Prevention.
• COX-2 inhibitors may prevent colon and breast cancer. COX-2 inhibitors may cause heart problems. Because COX-2 inhibitors may cause heart problems there have not been many studies on their use to prevent cancer. For more information, see Colorectal Cancer Prevention and Breast Cancer Prevention.

Studies have shown that weight loss surgery lowers cancer risk.

Weight loss surgery, also called bariatric surgery, is a procedure that people with obesity can have to lose weight and improve their overall health and quality of life. The surgery changes the anatomy of the stomach or changes the way the body absorbs nutrients. A person who undergoes this procedure will lose a lot of weight and as a result, will have a decreased risk of cancers that are linked to being overweight.

See the NCI website for more information about cancer prevention.

Aspirin has not been shown to prevent most cancers.

Aspirin has been studied as chemoprevention. The studies show mixed results but most have shown that aspirin does not prevent cancer. However, there is evidence that taking aspirin for long periods of time may prevent colorectal cancer in certain people. For more information, see Colorectal Cancer Prevention.

Results from a randomized trial suggest that taking aspirin may make cancer grow more quickly in the elderly, but longer follow up is needed to confirm these results.

Bleeding in the gastrointestinal tract or brain is a side effect of aspirin. Even though aspirin has not been shown to reduce the risk of most cancers, it has many uses, including helping to lower the chances of dying from heart disease. Before beginning long-term aspirin use, it is important to talk with your doctor about the related benefits and harms.

Vitamin and dietary supplements have not been shown to prevent cancer.

An intervention is a treatment or action taken to prevent or treat disease, or improve health in other ways.

There is not enough proof that taking multivitamin and mineral supplements or single vitamins or minerals can prevent cancer. The following vitamins and mineral supplements have been studied, but have not been shown to lower the risk of cancer:

• Vitamin B6.
• Vitamin B12.
• Vitamin E.
• Vitamin C.
• Beta carotene.
• Folic acid.
• Selenium.
• Vitamin D.

The Selenium and Vitamin E Cancer Prevention Trial (SELECT) found that vitamin E taken alone increased the risk of prostate cancer. The risk continued even after the men stopped taking vitamin E. Taking selenium with vitamin E or taking selenium alone did not increase the risk of prostate cancer.

Vitamin D has also been studied to see if it has anticancer effects. Skin exposed to sunshine can make vitamin D. Vitamin D can also be consumed in the diet and in dietary supplements. Taking vitamin D in doses from 400–1100 IU/ day has not been shown to lower or increase the risk of cancer.

The VITamin D and OmegA-3 TriaL (VITAL) is under way to study whether taking vitamin D (2000 IU/ day) and omega-3 fatty acids from marine (oily fish) sources lowers the risk of cancer.

The Physicians' Health Study found that men who have had cancer in the past and take a multivitamin daily may have a slightly lower risk of having a second cancer.

See the following PDQ summaries for more information:

• Breast Cancer Prevention
• Colorectal Cancer Prevention
• Lung Cancer Prevention
• Prostate Cancer Prevention

New ways to prevent cancer are being studied in clinical trials.

Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.

About PDQ

Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.

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Purpose of This Summary

This PDQ cancer information summary has current information about cancer prevention. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

Reviewers and Updates

Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.

The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Screening and Prevention Editorial Board.

Clinical Trial Information

A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Clinical trials can be found online at NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).

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The best way to cite this PDQ summary is:

PDQ® Screening and Prevention Editorial Board. PDQ Cancer Prevention Overview. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/about-cancer/causes-prevention/patient-prevention-overview-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389424]

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