A Challenge for the New Century

The article by Dr Parkin in this issue emphasises once again the striking variation in the incidence of common cancers across the world. Even within individual regions, variation can be great. Such observations, particularly when combined with migration studies, can, as Dr Parkin points out, be of major value in identifying important aetiological factors.

Equally important, it is now becoming apparent that cancers that appear to be histologically similar may have strikingly different mechanisms of molecular pathogenesis. For example, the various steps in the molecular pathogenesis of colorectal cancer may vary in different areas of the world. Such observations lead us to believe that treatments developed and proved in one region may not necessarily be beneficial to patients in other parts of the world. Furthermore, as we increasingly develop targeted and rationally designed anti-cancer agents such as monoclonal antibodies to growth receptors, it becomes important to know whether or not the frequency with which these targets are expressed varies among differing populations.

All these observations provide a rich source of potential research topics for those of us involved in the field of Asian cancers. The importance of comparing the molecular pathology of our cancers with those of the west and undertaking clinical trials within specific populations is going to be a major task for the first decade of the new century.

Professor Philip J Johnson

Editor-in-Chief