[The road to prevention - navigating vision zero strategies in oncology]

Modern medicine, despite successful strategies to reduce preventable deaths in areas like traffic and workplaces, lacks comparable strategies. As cancer incidences are on the rise globally, early detection and intervention by targeted therapies can significantly improve treatment success. Furthermore, over 50% of severe cancer cases could be avoided or detected very early through targeted prevention. Especially for primary preventive measures so-called "Vision Zero" concepts could already be a reality today. Studies show the effectiveness and safety of the HPV vaccine, leading to significant reductions in HPV-associated cancers in countries where vaccination coverage is high. Despite improved national efforts, Germany ranks second to last in a European comparison of vaccination rates in eligible girls and boys.Similar trends are seen for early cancer detection programs. Only a fraction of eligible Germans participates in colorectal cancer screening, while the national program in the Netherlands achieves a 71% participation rate by being a low threshold offer. Molecular profiling and biomarker-guided therapy decisions after initial tumor diagnosis offer efficient and quality-assured treatment options. Installment of nationwide networks, that combine clinical competence centers and decentralized providers, enable a democratized access to modern diagnostics and precision treatment options.Vision Zero strategies, established in many societal areas, could be a blueprint for similar approaches in modern oncology. Despite significant health expenditures, the share for preventive measures remains low. Studies show that investments in prevention not only improve health but also have a high return on investment. A Vision Zero in oncology could not only improve care but also cut overall costs.