Behavioral Oncology and the War on Cancer: Partnering with Biomedicine Michael E. Stefanek, 1 Michael A. Andrykowski, 3 Caryn Lerman, 4 Sharon Manne, 5 and Karen Glanz 2 on behalf of the AACR Behavioral Science Task Force 1 Behavioral Research Center, American Cancer Society; 2 Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia; 3 University of Kentucky College of Medicine, Lexington, Kentucky; 4 Tobacco Use Research Center, Department of Psychiatry and Annenberg Public Policy Center, Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania; and 5 Fox Chase Cancer Center, Cheltenham, Pennsylvania Abstract The call for interdisciplinary research in the war on cancer has escalated over the past several years. Behavioral science has played a key role in cancer control, and several exciting opportunities exist and will develop with the ongoing significant advances made in biomedical science. The current article briefly reviews the maturity of behavioral science in the areas of prevention, early detection, and survivorship and how the partnership of behavioral and biomedical science can effectively impact cancer incidence, morbidity, and mortality. [Cancer Res 2009;69(18):7151–6] Introduction According to the American Cancer Society, there were over 1.4 million new cancer cases and 550,000 cancer deaths in 2008 (1). In a global population exceeding 6 billion in the year 2002, there were approximately 10.9 million new cancer cases, 6.7 million cancer deaths, and 22.4 million persons surviving from cancer diagnosed in the previous 5 years (2). In 2020, it is expected that the world’s population will increase to 7.5 billion, with 15 million new cancer cases and 12 million cancer deaths. Since 1970, the number of cancer survivors has increased four-fold, with cancer survivors representing roughly 3.5% of the U.S. population and 5-year survival rates increasing into the 60% range. This raises issues related to long-term and late effects of cancer treatment and the realization that cancer survivors represent 16% of all new primary cancers (3). Over the past decade, increased attention has focused on the role of behavioral science in the war against cancer, from prevention to survivorship. The National Cancer Institute (NCI) created the Division of Cancer Control and Population Sciences and, within this Division, a formal Behavioral Research Program. The American Cancer Society created an intramural research program, the Behavioral Research Center, in addition to increasing attention to extramural funding of behavioral research. The AACR initiated a Task Force on Behavioral Science in 2004 to attempt to integrate behavioral science into the biomedical cancer research agenda. The Society of Behavioral Medicine, the American Public Health Association, and the American Society for Preventive Oncology (ASPO) have all increased their organizational activities related to behavioral oncology. Finally, NCI-designated Comprehensive Can- cer Centers must ‘‘feature vigorous interactions across its research areas and facilitate collaborations between laboratory, behavioral, epidemiologic, and clinical scientists.’’ In sum, the field of behavioral oncology has come of age, and behavioral researchers are eager to increase collaborations with the biomedical cancer research community. In this Perspectives article, we share with our medical colleagues the promise of behavioral science in the areas of prevention, early detection, and survivorship, focusing on ‘‘translational’’ research, defined by the NCI’s Translational Research Working Group as research that ‘‘transforms scientific discoveries arising from laboratory, clinical, or population studies into clinical applications to reduce cancer incidence, morbidity, and mortality’’ (4). Behavioral Oncology across the Cancer Continuum To best illustrate the current range of work and promise of behavioral science in translational research related to cancer, this article includes examples moving across the cancer continuum from prevention to early detection to cancer survivorship (4). In addition, there is ongoing behavioral research in areas with the potential to cut across the cancer continuum, and these are noted in the final section of the article. Prevention Tobacco use is the single greatest preventable cause of cancer mortality in the United States. Despite this, approximately one in four Americans are current smokers, and these rates are as high as one in two in the developing world. Behavioral science research has made important contributions to our understanding of the biobehavioral basis of nicotine dependence, has acceler- ated progress in the development of preventive and therapeutic interventions, and has generated an important evidence base for policy changes related to tobacco products and policies worldwide (5). Evidence from animal models has identified adolescence as a critical period for susceptibility to the addictive effects of tobacco via the effects of nicotine on brain circuits, which regulate attention, affect, and executive cognitive function (6). Social researchers have long recognized the role of social norms on increased adolescent risk-taking behaviors from multiple behav- ioral science perspectives (7). The most effective programs to prevent smoking initiation in youth are those combining health communication strategies to alter normative beliefs and enhance perceptions of harm with behavioral treatments to enhance social and personal competence in resisting peer influences (8). These efforts are being extended to special populations of youth with medical and psychiatric comorbidities who may have increased susceptibility to tobacco use (9). Requests for reprints: Michael E. Stefanek, Behavioral Research Center, American Cancer Society, 250 Williams Street, Northwest, Atlanta, GA 30303. Phone: 404-329- 7795; Fax: 404-929-6832; E-mail: michael.stefanek@cancer.org. I2009 American Association for Cancer Research. doi:10.1158/0008-5472.CAN-08-4005 www.aacrjournals.org 7151 Cancer Res 2009; 69: (18). September 15, 2009 Perspectives