Epigenome-based cancer risk prediction: rationale, opportunities and challenges

Key Points Epigenetic misprogramming is an essential component of cancer development. DNA methylation-based risk-prediction models provide novel opportunities for risk-tailored screening and prevention of cancer. Multidisciplinary collaborative research is needed to overcome the scientific challenges associated with the discovery of DNA methylation markers for risk-prediction, such as identifying surrogate tissues and developing novel analytical methods. Implementation of epigenome-based risk-tailored screening and prevention programmes requires several ethical, legal, social, organizational and economic challenges to be addressed in addition to the engagement of policymakers, health-care professionals and the public.