Article by Natalia de la Figuera – Co-Founder and COO of GENESIS Biomed

• The current 21st century will be remembered for the shift from treatment-centred medicine to prevention-oriented medicine.

• One of the main tools used in preventive medicine is the use of vaccines.

• Population screening and predictive genetics allow early identification of diseases or risk factors.

• Massive data collection accelerated by the digitisation of healthcare, as well as artificial intelligence, is becoming an essential pillar for prevention.

For much of the 20th century, medicine focused on treating diseases once they had occurred. Advances in surgery, pharmacology and intensive care radically changed life expectancy and quality of care. In contrast, in the 21st century we are witnessing a strategic shift towards prevention. Advances in medicine together with the integration of disruptive technologies such as artificial intelligence are making possible what was previously unthinkable: prevention. This transformation involves not only a new vision of healthcare, but also a technological and scientific revolution.

Moreover, prevention offers not only clinical but also economic benefits. Prevention has traditionally been an undervalued strategy compared to therapy. From a public health perspective, preventing a disease is much more cost-effective than treating it. The concept of disease shifts from an entity that is treated after the fact to a condition that can be prevented or reversed using different instruments, some of which are listed below:

Vaccines

Preventive vaccination programmes have been shown to dramatically reduce the burden of infectious diseases, resulting in fewer hospitalisations, fewer days off work and, ultimately, fewer deaths. Since the implementation of mass vaccination campaigns against infectious diseases such as polio, measles and hepatitis B, we have learned that prevention saves millions of lives and significantly reduces healthcare costs. In this context, vaccines represent one of the most effective tools to achieve this goal.

However, while most known vaccines target infections, there are successful examples of vaccines that reduce cancer incidence by preventing infection with cancer viruses. The human papillomavirus (HPV) vaccine, for example, has been shown to be highly effective in preventing cervical cancer, as well as other HPV-related oral, anal and genital cancers. Similarly, the hepatitis B vaccine has contributed to the reduction of liver cancer in areas with a high prevalence of the virus. These experiences have taught us that certain cancers can be indirectly prevented by avoiding associated viral infections.

But now the frontier is expanding to an even more ambitious goal: designing vaccines that act directly on tumour cells or oncogenic mechanisms without the need for an intermediate infectious agent. In this case, vaccines are targeted at patients who have already been diagnosed with cancer. Unlike prophylactic vaccines, these aim to teach the immune system to recognise specific tumour antigens, triggering a cellular response capable of eliminating the malignant cells and returning the patient to a healthy state. Among the most advanced cases is the mRNA-based therapeutic vaccine developed by BioNTech to treat advanced melanoma. Another example is Moderna, which is collaborating with Merck to develop mRNA vaccines against several types of cancer. These initiatives demonstrate that the successful model of mRNA vaccines against COVID-19 can be transferred to cancer, albeit with much greater complexity.

Screening and early diagnosis

Another pillar of preventive medicine is screening programmes. These interventions, aimed at large asymptomatic population groups, allow the detection of diseases in early stages, when they are more treatable and even curable. In this case, mainly IVD (in vitro diagnostic) systems are used, as in the case of the faecal occult blood test, which together with colonoscopy is used for the detection of colorectal cancer, as well as diagnostic systems such as mammography for the detection of breast cancer or the identification of HPV (human papillomavirus) in a cytology to detect cervical cancer.

These are clear examples of how early detection can reduce the mortality associated with these cancers by significant percentages and are now a fundamental part of public health strategy.

Genetic prediction and personalised medicine

Prevention has also taken a qualitative leap forward thanks to the development of personalised medicine. Through genetic analysis, it is possible to identify people at high risk of suffering from certain diseases, such as hereditary breast cancer (ex. BRCA1 and BRCA2 mutations), cardiovascular diseases or rare diseases. With this information, personalised preventive strategies can be designed, ranging from more frequent medical check-ups to the adoption of preventive treatments or even prophylactic surgeries. The predictive approach, tailored to the patient’s genomic profile, represents a crucial step towards more effective and targeted prevention.

Digital health and remote monitoring, with the involvement of AI

Finally, digitalisation is playing a key role in the transition towards prevention. Mobile applications, wearable devices and digital health platforms allow health parameters such as blood pressure, heart rate, sleep and glucose levels to be constantly monitored. This massive collection of data generates invaluable information which, due to its volume and complexity, requires advanced technologies for its effective analysis. In this context, artificial intelligence becomes a key tool. Using machine learning and deep learning algorithms, AI is capable of identifying hidden patterns and complex correlations that can be used to make predictions about the future risk of developing diseases such as cardiovascular pathologies, diabetes or neurodegenerative disorders, even before they manifest themselves clinically. In this way, digital health, supported by artificial intelligence, is revolutionising the relationship between patients and healthcare professionals, and becoming an essential pillar for anticipating disease and improving health outcomes.

The current 21st century will be remembered for the shift from treatment-focused to prevention-focused medicine. Vaccines, screening programmes, predictive genetics and digital health are tools that, combined with healthy lifestyles, are revolutionising the way we deal with disease. As science and technology converge, the barriers between prevention and therapy are blurring, allowing hybrid approaches that simultaneously prevent, treat and cure. We are, therefore, on the verge of a medical revolution in which prevention will be as strategic as cure.