Cancer Prevention And Early Detection - NCI

Cancer Prevention and
Early Detection

Cancer Prevention Working Definition
ASCO CAPC
• A reduction in the risk of developing clinically
evident cancer, whether first or second primary
cancer, or of developing intraepithelial neoplasia
(IEN), a frequent cancer precursor. Inherent in this
definition is the early detection and treatment of
IEN .

Earlier Definition
• "primary" prevention (intervention for relatively
healthy individuals with no invasive cancer and an
average risk for developing cancer).
• "secondary" prevention (intervention for patients
determined by early detection to have
asymptomatic, subclinical cancer).
• "tertiary" prevention (symptom control,
rehabilitation, or other issues in patients with
clinical cancer .

• Cancer prevention science and practice are just beginning to gain
public, academic, government and industry recognition as a major
aspect of oncology .
• Cancer prevention spans a wide range of disciplines, including
population, behavioral, and social sciences; diagnostics; and clinical
therapeutics (chemoprevention, risk reduction).
• Diverse training and skills are required to fully address the spectrum of
carcinogenesis and its control.
• Risk-based management is the process of determining the best cancer
prevention approaches for specific cancer risks

ASCO Strategic Plan 2004–2007: Goal
Cancer Prevention and Control
• Advocate for rapid, worldwide reduction and ultimate elimination of
tobacco products and exposure to environmental tobacco smoke, in
collaboration with other organizations and professional societies
• Increase core knowledge about cancer risk and risk reduction through
new education initiatives
• Promote clinical, behavioral, and translational research, and education
and training in cancer prevention and control
• Work to eliminate healthcare disparities in cancer risk assessment and
early detectionProvide prevention-oriented messages for individuals with
a prior history of cancer and for the general public

Prevention
Cancer can be caused by a number of different factors and
may develop over a number of years. Some risk factors can
be controlled. Choosing the right health behaviors and
preventing exposure to certain environmental risk factors can
help prevent the development of cancer. For this reason, it is
important to follow national trends data to monitor the
reduction of these risk factors.

Behavioral Factors
Scientists estimate that as many as 50 to 75 percent of cancer deaths in the United States are
caused by human behaviors such as smoking, physical inactivity, and poor dietary choices.
• Not using cigarettes or other tobacco products:
• Not drinking too much alcohol
• Eating five or more daily servings of fruits and vegetables
• Eating a moderate-fat diet
• Consuming a diet in which total calories eaten are balanced with calories
expended by physical activity
• Maintaining or reaching a healthy weight
• Being physically active
• Protecting skin from sunlight

Behavioral Factors
• Smoking causes about 30 percent of all U.S. deaths from cancer. Avoiding
tobacco use is the single most important step Americans can take to reduce the
cancer burden in this country.
• Obesity and physical inactivity cause about 25 to 30 percent of several of the
major cancers in the U.S., including colon, breast, endometrial, kidney, and
esophageal cancers. Obesity is estimated to cause 14 percent of cancer deaths
in men and 20 percent of cancer deaths in women.
• Additional important steps include maintaining a healthy weight, being physically
active, eating a moderate-fat diet and enough fruits and vegetables, balancing
calories with physical activity, avoiding too much alcohol, and protecting skin
from sunlight.

Tobacco Control
• Increasing efforts to discourage tobacco use, particularly among the young
• Raising federal excise taxes by at least $2 per pack and encouraging states to consider
tobacco taxes as a first resort in revenue enhancement
• Ensuring that tobacco settlement funds be devoted only to health-related projects,
including medical treatment, biomedical research, and tobacco prevention efforts
• Comprehensively reforming third-party payment for tobacco cessation efforts
• Additional restriction of secondhand smoke in any places where the public may
congregate
• Supporting necessary research into tobacco addiction, toxicities, and prevention strategies
• Enhancing global tobacco control, including a halt of United States government promotion
of tobacco products

Environmental Factors
• Certain chemicals, biological agents, toxins, etc.
are associated with cancer development.
• Second hand tobacco smoke (also known as
environmental tobacco smoke)
• Pesticides
• Dioxins

Early Detection
The use of screening tests to detect cancers early may
allow patients to obtain more effective treatment with
fewer side effects. Patients whose cancers are found early
and treated in a timely manner are more likely to survive
these cancers than are those whose cancers are not
found until symptoms appear.

Early Detection
• Mammography (for breast cancer)
• Pap test (for cervical cancer)
• Fecal occult blood test (for colorectal cancer)
• Colorectal endoscopy (sigmoidoscopy or colonoscopy
for colorectal cancer)

Report Highlights
2005 Update
• Death rates for the four most common cancers (prostate, breast, lung, and colorectal), as well as for all
cancers combined, continue to decline.
• The rate of cancer incidence has been relatively stable since the mid 1990s.
• Some prevention behaviors have shown improvement. Adult smoking is down dramatically since the
1960s. Alcohol and fat consumption are headed down, while fruit and vegetable consumption is up only
slightly since about 1990.
• Youth smoking was on the rise during 1990s, but has shown declines since 1997.
• The use of screening tests for breast and cervical cancers is high and remained stable between 2000
and 2003. Screening for colorectal cancer remains low, despite its proven effectiveness..
• People are doing slightly more to protect themselves from the sun .

Breast Cancer

Screening by Mammography
Mammography use rose steadily in women ages 40 and older until
2000 and has been stable since. The 2010 goal for all women was met
by 2000, though disparities remain among racial/ethnic, geographic,
and low-income groups. Statement of benefit
Based on fair evidence, screening mammography in
women aged 40 to 70 years decreases breast cancer
mortality.
The benefit is higher for older women, in part because
their breast cancer risk is higher.

Screening by Clinical Breast
Examination
Statement of benefits
Based on fair evidence, screening by
clinical breast examination reduces
breast cancer mortality.

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