Insights from various areas of carcinogenesis can now be blended into cohesive and molecular hypotheses testable at a clinical level. One can now define new areas such as biochemical epidemiology. Whereas previously one thought of identifying individuals at high risk for cancer due to life-style or occupation, one can now propose to identify the susceptible individual at the molecular level for some cancers. Theoretically, if past exposure to carcinogens were significant, we may now be able to measure the exact sites of attack and damage in cellular DNA. We now have oncogenes as the probable targets. Treatment potential with highly specific molecular tools should not be far behind. As often cited before, the first priority of the NCI has always been basic research. The present excitement in the area of oncogenes has certainly been a shining example of research success.

As is always the case in a rapidly moving field, there are optimists and pessimists. There are fears of overpromise and dangers of lack of swift application. NCI's view can be summed up this way. Oncogene research is important if only for its implications in developmental biology. It needs no other reason for support or excitement. It also will be important to our understanding of cancer; how important, we do not yet know. We believe it will lead to practical applications in diagnosis, prevention, and treatment; how practical and how soon remain unknowns. By definition then, we are clearly optimists, for which no apologies are offered. The danger of overpromise, it seems to these authors, is exceeded by the risk of failure to pursue and apply one of the most exciting areas of research that brings molecular biology to the crowded bedside of the cancer patient. A good dose of optimism seems about right to make a little room.

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Adapted from the testimony before the Subcommittee on Investigations and Oversight of the Committee on Science and Technology, United States House of Representatives.

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