The Role of the Extracellular Matrix in Cancer Prevention

The extracellular matrix (ECM) is a major driver of tumorigenesis, yet its role in cancer prevention has received relatively little attention. Here, we discuss studies linking the ECM to cancer initiation with an emphasis on ECM stiffness and remodeling, pericytes, and hyaluronan (hyaluronic acid). We then share our thoughts on how an ECM viewpoint could lead to new insights and directions in cancer-prevention research. Topics discussed include mouse experiments, clinical studies, risk factors, biomarkers for risk prediction or the early detection of cancer, surrogate endpoints, and targets for preventive interventions.