ON CANCER PREVENTION AND EARLY
It is well known that in some cases cancer can be prevented
and, in others, early detection can reduce mortality. In U.S. and worldwide our aim as oncology professionals is
to reduce cancer morbidity and mortality.
This is best accomplished by cancer prevention and early detection. Here I will try to describe the six
most influential groups of individuals and agents who I believe can and should
be involved in this important healthcare process.
Each individual should take charge
of his or her health, assume responsibility for preventing cancer that are
preventable, and adhere to available screening programs that have proven to be
of value. Healthy behaviors should
include avoiding smoking and obesity, regular exercising, maintaining a
balanced diet, and avoiding extraneous poisoning and hazardous exposure.
GOVERNMENT: The World Health Organization (WHO), the Union for
International Cancer Control (UICC), the U.S. Surgeon General, and other
officials and organizations have recommended that governments prepare national
cancer control programs promoting primary and secondary prevention. It is the role of the government to
secure continuing improvement in the general health of population by imposing
legislative, regulatory and environmental measures, as well as by launching
screening educational programs for the general public. Most governments (168 of 192 WHO member
states) have signed the WHO framework convention on tobacco control, although
not all nations have implemented all of its recommendations. This evidence-based treaty sets forth
worldwide standards on the dangers of tobacco and offers guidelines for
limiting its use. Governments
should also be responsible for public health by minimizing occupational cancers
and exposures to known carcinogens, (e.g. asbestos and lead) and by preparing
national vaccination programs for diseases such as hepatitis B which is widely
implemented worldwide and human papilloma virus which is implemented in the
PRIMARY CARE PHYSICIANS: Primary care physicians
should help ed ucate patients that some
cancers can be prevented by behavior modification and that other cancers, if
detected early, can be cured. In
addition, these frontline doctors need to raise awareness of the importance of
cancer screening and cancer symptoms.
When seeing a patient with symptoms, the primary care clinician should
be able to diagnose or rule out cancer.
HEALTH INSURANCE PROVIDERS: Health insurance
programs have essential role in enabling access to and provision of cancer
care. These programs also have a
clear role in access to and provision of cancer screening which can improve
compliance rates. Four factors are
responsible for the success of cancer screening--Public policy, organizational
system, the practice setting, and clinician/patient participation. Strategies targeted at each of these
levels can improve cancer screening.
Using multi-strategies with synergistic efforts can be the most
ONCOLOGISTS: As experts in cancer care, oncologists must be involved in
the community based cancer prevention studies and community education,
including efforts related to cancer prevention and screening. The target population here can include
but not limited to cancer survivors, families, health groups, high risk groups,
general practitioners, health personnel as well as health authorities. American Society of Clinical Oncology
(ASCO) which is the largest and leading oncology organization established
cancer prevention committee in 2002 which is committed to supporting
oncologists in the risk assessment and prevention.
The role of the cancer society
includes the following functions--
- To serve as a catalyst in
assuring that effective prevention and early detection programs are fully
and properly implemented by health authorities.
- To disseminate reliable
information and conduct educational programs for the general population,
high risk groups, and patients with cancer.
- To serve as (watchdog) in
efforts to improve treatment modalities and rehabilitation methods for
patients, their families and survival.
- To conduct advocacy and
lobbying activities so that the comprehensive oncology network and its
targets are placed high on the national health agenda.
In summary, I believe reduction of cancer morbidity and
mortality is achievable via enhanced cooperation and coordination among the six
agents described herein.
Everybody, should be responsible and accountable to do the utmost to
accomplish the important and novel mission of reducing suffering caused by
cancer. This noble mission is
achievable and should be done on the national scale.
Haitham Al-Okk, MD