Role of experimental and epidemiological evidence of carcinogenicity in the primary prevention of cancer.

Experimental chemical carcinogenesis, which included long-term tests in experimental animals,had a dominating role in cancer research between the 1920s and the late 1960s. Two events marked a certain decline of confidence in the ability of experimental results to predict human risks: the incapacity of developing methods to identify agents acting on the different steps of the carcinogenesis process, and the incapacity to reproduce experimentally the strong evidence of carcinogenicity of tobacco smoke provided by epidemiological studies. It was at that time that epidemiologists and biostatisticians developed criteria for assessing the causation of chronic-degenerative diseases relying primarily on epidemiological evidence. In 1969 the International Agency for Research on Cancer (IARC) did initiate a programme for identifying the cause of cancer with the aim of promoting the primary prevention of cancer. The programme is focused on the evaluation of the carcinogenicity of environmental agents on the basis of both the experimental and epidemiological evidence and, since the 1990s, a balanced use of the new tools provided by advances in toxicology, molecular biology and genetics. A strong point of the IARC programme is that in the absence of adequate human data it is reasonable and prudent to regard agents for which there is sufficient experimental evidence of carcinogenicity as if they were carcinogenic to humans.