Abstract
Cancer control encompasses the whole spectrum from prevention and early diagnosis to treatment and palliation. The key to the future of cancer control will be to establish multidisciplinary approaches to each type of cancer across this spectrum. For primary prevention this requires some understanding of the causes of each cancer. Although understanding of the aetiology of cancer has greatly improved, prospects for the primary prevention of many common cancers remain remote. Other approaches currently under evaluation include chemoprevention and the use of biomarkers (discussed last week). The identification of predisposing genes for some of the common cancers may have a considerable impact on the ability to recognise those at risk. Overall, however, mortality trends indicate that reduction of smoking remains the main priority for cancer prevention in the United Kingdom. For primary care teams, brief interventions to reduce smoking are likely to achieve the greatest benefit. This should be seen as part of broader policies aimed at achieving change in the whole population. The government must acknowledge its major responsibility to cancer prevention by banning all forms of advertising and promotion of tobacco.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Baum M., Ziv Y., Colletta A. Prospects for the chemoprevention of breast cancer. Br Med Bull. 1991 Apr;47(2):493–503. doi: 10.1093/oxfordjournals.bmb.a072487. [DOI] [PubMed] [Google Scholar]
- Calnan M., Cant S., Williams S., Killoran A. Involvement of the primary health care team in coronary heart disease prevention. Br J Gen Pract. 1994 May;44(382):224–228. [PMC free article] [PubMed] [Google Scholar]
- Charlton B. G., Calvert N., White M., Rye G. P., Conrad W., van Zwanenberg T. Health promotion priorities for general practice: constructing and using "indicative prevalences". BMJ. 1994 Apr 16;308(6935):1019–1022. doi: 10.1136/bmj.308.6935.1019. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chouillet A. M., Bell C. M., Hiscox J. G. Management of breast cancer in southeast England. BMJ. 1994 Jan 15;308(6922):168–171. doi: 10.1136/bmj.308.6922.168. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Coggon D., Inskip H. Is there an epidemic of cancer? BMJ. 1994 Mar 12;308(6930):705–708. doi: 10.1136/bmj.308.6930.705. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Evans D. G., Fentiman I. S., McPherson K., Asbury D., Ponder B. A., Howell A. Familial breast cancer. BMJ. 1994 Jan 15;308(6922):183–187. doi: 10.1136/bmj.308.6922.183. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ford D., Easton D. F., Bishop D. T., Narod S. A., Goldgar D. E. Risks of cancer in BRCA1-mutation carriers. Breast Cancer Linkage Consortium. Lancet. 1994 Mar 19;343(8899):692–695. doi: 10.1016/s0140-6736(94)91578-4. [DOI] [PubMed] [Google Scholar]
- Gillis C. R., Hole D. J., Still R. M., Davis J., Kaye S. B. Medical audit, cancer registration, and survival in ovarian cancer. Lancet. 1991 Mar 9;337(8741):611–612. doi: 10.1016/0140-6736(91)91673-i. [DOI] [PubMed] [Google Scholar]
- Hall P., Boice J. D., Jr, Berg G., Bjelkengren G., Ericsson U. B., Hallquist A., Lidberg M., Lundell G., Mattsson A., Tennvall J. Leukaemia incidence after iodine-131 exposure. Lancet. 1992 Jul 4;340(8810):1–4. doi: 10.1016/0140-6736(92)92421-b. [DOI] [PubMed] [Google Scholar]
- Hunt S. M., Macleod M. Health and behavioural change: some lay perspectives. Community Med. 1987 Feb;9(1):68–76. doi: 10.1093/oxfordjournals.pubmed.a043908. [DOI] [PubMed] [Google Scholar]
- Kedar R. P., Bourne T. H., Powles T. J., Collins W. P., Ashley S. E., Cosgrove D. O., Campbell S. Effects of tamoxifen on uterus and ovaries of postmenopausal women in a randomised breast cancer prevention trial. Lancet. 1994 May 28;343(8909):1318–1321. doi: 10.1016/s0140-6736(94)92466-x. [DOI] [PubMed] [Google Scholar]
- King M. C., Rowell S., Love S. M. Inherited breast and ovarian cancer. What are the risks? What are the choices? JAMA. 1993 Apr 21;269(15):1975–1980. [PubMed] [Google Scholar]
- Kreuter M. W. Human behavior and cancer. Forget the magic bullet! Cancer. 1993 Aug 1;72(3 Suppl):996–1001. doi: 10.1002/1097-0142(19930801)72:3+<996::aid-cncr2820721308>3.0.co;2-o. [DOI] [PubMed] [Google Scholar]
- Lippman S. M., Benner S. E., Hong W. K. Chemoprevention. Strategies for the control of cancer. Cancer. 1993 Aug 1;72(3 Suppl):984–990. doi: 10.1002/1097-0142(19930801)72:3+<984::aid-cncr2820721306>3.0.co;2-0. [DOI] [PubMed] [Google Scholar]
- Mant D. Health checks--time to check out? Br J Gen Pract. 1994 Feb;44(379):51–52. [PMC free article] [PubMed] [Google Scholar]
- McArdle C. S., Hole D. Impact of variability among surgeons on postoperative morbidity and mortality and ultimate survival. BMJ. 1991 Jun 22;302(6791):1501–1505. doi: 10.1136/bmj.302.6791.1501. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Meyskens F. L., Jr Biomarker intermediate endpoints and cancer prevention. J Natl Cancer Inst Monogr. 1992;(13):177–181. [PubMed] [Google Scholar]
- Mulshine J. L., Jett M., Cuttitta F., Treston A. M., Quinn K., Scott F., Iwai N., Avis I., Linnoila R. I., Shaw G. L. Scientific basis for cancer prevention. Intermediate cancer markers. Cancer. 1993 Aug 1;72(3 Suppl):978–983. doi: 10.1002/1097-0142(19930801)72:3+<978::aid-cncr2820721305>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]
- Peto R., Lopez A. D., Boreham J., Thun M., Heath C., Jr Mortality from tobacco in developed countries: indirect estimation from national vital statistics. Lancet. 1992 May 23;339(8804):1268–1278. doi: 10.1016/0140-6736(92)91600-d. [DOI] [PubMed] [Google Scholar]
- Spitz M. R., Bondy M. L. Genetic susceptibility to cancer. Cancer. 1993 Aug 1;72(3 Suppl):991–995. doi: 10.1002/1097-0142(19930801)72:3+<991::aid-cncr2820721307>3.0.co;2-5. [DOI] [PubMed] [Google Scholar]
- Stiller C. A. Survival of patients with cancer. BMJ. 1989 Oct 28;299(6707):1058–1059. doi: 10.1136/bmj.299.6707.1058. [DOI] [PMC free article] [PubMed] [Google Scholar]