Neoplastic progression is an evolutionary process and cancer prevention is successful to the extent that it can impact that process, reducing the likelihood that premalignant cells will evolve invasive or metastatic phenotypes. Despite the centrality of somatic evolution in cancer progression, evolutionary tools and analyses have rarely been applied to the development and implementation of interventions to reduce cancer incidence. Conceptual barriers such as cognitive biases, misperceptions about the nature of cancer, or the use of misleading metaphors may interfere with the effective incorporation of evolutionary principles into cancer prevention and treatment. We analyzed cancer articles for evidence of several biases that are likely to interfere with evolutionary thinking and conducted surveys to measure these cognitive biases. We found evidence for several biases, including a failure to recognize the mutability of neoplasms. Further, our surveys indicated that respondents favor metaphors for cancer (as an invading enemy or parasite) that may bias towards overly aggressive interventions. By identifying cognitive barriers to the penetration of evolutionary principles in cancer research and prevention, we will be able to more effectively offset these biases and expand the conceptual framing of cancer so as to facilitate cancer prevention research, improve patient management and prevent over-treatment.
Citation Information: Cancer Prev Res 2010;3(12 Suppl):B2.