breakout.txt
Jules J. Berman
Nov. 5, 2004

Questions for Precancer sessions:

For terminology/classification group

1. Does the concept of IEN sufficiently account for all types of 
precancers?  Or, should IEN be considered one of many classes of 
precancers?  

2. Are there as many different types of precancers as there are 
different types of cancers, or do a few precancer-types account 
for all the cancers we see?

3. Are there de-novo cancers that have no precancer phase, that 
begin as biologically complete cancer from a single cell?  

4. Are there biologically diverse classes of precancers?  If so, 
can the different classes of precancers be distinguished by 
class-specific markers?

5. Are there crypto-precancers that account for a portion of the 
cancers we see?  Should we be looking for new precancers?

6. What do we know about the biology of precancer regression?  Can 
we be certain that agents incuding precancer regression will reduce 
the incidence of cancer?  Is precancer regression a property of some 
types of precancer but not of other types, or is it a general property 
of precancers?

7.  Should this group begin an effort to list and classify all the 
human precancers?  What information would be need to collect to 
properly classify the precancers?

8. What do we need to learn about the precancers that would accelerate 
progress in this field?

9. Do pathologists know enough about the precancers to provide 
clinicians with all the descriptive information needed for the optimal 
treatment of patients? 

For precancer prevention/diagnosis/treatment group

1. Are pathologists doing a good job at diagnosing precancers and 
providing clinicians with all the descriptive information needed for 
the optimal treatment of patients? 

2. In the U.S., is there consistency in the way that clinical 
surveillance for precancers is done?

3. In the U.S., is there consistency in the way that precancers are 
treated?

4. Are there lessons to be learned from the way that precancers are 
detected and treated in other countries?

5. What are the implications, to a patient, of having a diagnosis of 
"precancer?"  

6. What are the implications, to epidemiologists, of having a formal 
disease category of "precancer," that might include some lesions that 
were formerly identified as cancers or other lesions that were formerly 
omitted from listings of neoplasms?

7. What are the implications to cancer researchers, of having a formal 
classification of precancers?  Will this change the way that past 
studies have collected and analyzed data on tumor specimens? 

8.  When you treat a precancer, are you practicing preventive medicine, 
or are you treating clinically significant disease?  What are the 
implications of this distinction?

9. Should be be doing more screening for precancers?  

10. How do we decide what screening/detection is worthwhile and what 
is not?


For mouse models group

1. Do mice have precancers that are biologically equivalent to human 
precancers?  

2. If an agent causes precancers in mice, is it a carcinogen?

3. How many of the mouse cancers have identifiable mouse precancers?  
What are they?

4. Of what value [to translational research] are mouse precancer models?

5. What are the mouse precancer models? [i.e. can a list be prepared?]

6. What general lessons [about precancers] have we learned from mouse 
models?

7. What questions [about precancers] can only be learned from mouse 
models?

8. What should medical pathologists know about the mouse precancers 
[important similarities and important differences?]

9. What are the ongoing studies with mouse precancers that are aimed 
at producing results that can be used to prevent, detect, diagnose or 
treat human cancers?

10. What future mouse precancer studies would be most useful in producing 
results that can be used to prevent, detect, diagnose or treat human 
cancers?