Hallmarks of the pre-disease state: prevention and control of the pre-disease state, a tipping point between health and disease

Complex diseases, including cancers, diabetes, and other chronic diseases, are not caused by individual genes or factors. Instead, they arise from dynamic interactions among multiple genetic, environmental, and lifestyle factors. Disease pathogenesis is a prolonged, dynamically evolving process, not a simple binary switch between health and disease. Between the states of health and manifest disease lies a crucial yet often overlooked intermediate phase: the pre-disease state, i.e., a tipping point that occurs just before the disease state 1 . This phase determines whether a disease will develop, when it might occur, and importantly, whether the disease process can be reversed. Preventive intervention during this stage, which occurs prior to disease onset, is therefore crucial for effective disease management and potential cure.