Cancer prevention in Primary care Cancer prevention: setting the scene

Abstract

Each year in the United Kingdom there are over 300,000 new cases of cancer and nearly 165,000 deaths from cancer. It is widely believed that as many as four fifths of all cancers are preventable by means that are already available. The Health of the Nation and the Europe Against Cancer programme have set targets and strategies for reducing the risk of cancer. An approach based on the whole population will achieve the greatest reductions in morbidity and mortality. Complementary to this is the individual approach, which can be based in primary care and targeted at high risk subjects. Health promotion and screening in primary care are not in themselves self evidently valuable. Their effectiveness must be tested rigorously and scientifically. Furthermore, because of limited time and resources, health education in primary care should be focused on interventions that are likely to achieve the greatest benefit, such as helping people to stop smoking.

Incidence, Mortality and Long–Term Survival from Prostate Cancer in Umbria, Italy, 1978–1994

“…The regional values were 0.10 lower at 5 years and 0.05 at 10 years in comparison with the mean for Italy. Compared with foreign cancer registries, Umbrian survival rates are much lower than values reported from Sweden and Geneva (table 7) [20, 21, 22, 23, 24, 25, 26]. The percentage of histologic verification for 1978–1982 was quite low (63%), though close to that reported by European cancer registries in the same period [13]; in general, the percentage of histologic confirmation was significantly lower for patients over 65 years and this finding could reflect a lesser aggressiveness of the diagnostic and therapeutic process in these patients.…”

Investigating the role of the general practitioner in cancer prevention: a mixed methods study

“…Danaei et al [8] analysed data from seven million cancer deaths worldwide and estimated that 35% of cancer deaths were attributable to nine potentially modifiable behavioural and environmental risk factors. Much of the modifiable risk factor avoidance and reduction in cancer prevention have been centred on lifestyle issues and behavioural change [13,14]. Cancer prevention, according to the National Cancer Institute (NCI), is both the promotion of healthy behaviours as well as the avoidance of risk factor behaviours.…”

“…Austoker [13] identified nine specific barriers to GPs participation in prevention activities. These included aspects such as a lack of motivation, training, time, support, appropriate health education resources and protocols; concerns with low success rates; inadequate financial reimbursement; and a failure to use the skills of other members of the primary care team.…”

Health Behaviors and Depressive Symptoms in Testicular Cancer Survivors

“…However, long-term testis cancer survivors (TCS) who were treated with cisplatin-based chemotherapy have an increased observed-to-expected (O/E) ratio of 1.4 for secondary neoplasia 2 and an increased O/E ratio ranging from 2.4 3 to 7.1 4 for cardiovascular morbidities. Behavioral factors such as smoking, diet, alcohol consumption, and cancer screening represent an important pathway for disease prevention 5,6 . Unfortunately, little is known about TCS' health beahviors.…”