nicable diseases. Some suggest that society has entered a third “public health revolution” with a focus on advancing health, with health defined following the World Health Organization’s formulation, as “physical, mental and social well-being, not merely the absence of disease and infirmity” (Breslow, 1999, p. 1031). The term health promotion is often coupled with that of disease prevention and has been defined as “the process of enabling people to increase control over, and to improve their health” (Breslow, 1999, p. 1030). The concept of health promotion has emerged, in part, because of increases in longevity and time spent without significant disability. Health promotion then “seeks the development of community and individual measures which can help people to develop lifestyles that can maintain and enhance the state of well-being” (Breslow, 1999, p. 1030). The concept of health promotion underlies many of the approaches to reducing the risk of cancer among individuals and populations.

In 2002 an estimated 1.3 million new cases of cancer were diagnosed and over half a million deaths were due to cancer. Cancer is a diverse set of conditions, but just four cancers contribute disproportionately to cancer’s toll, accounting for half of all newly diagnosed cases and deaths: cancers of the lung and bronchus, breast, prostate, and colon and rectum. Especially burdened by cancer are individuals who are elderly and socially and economically disadvantaged. Members of certain minority groups including African Americans are also more likely than others to suffer morbidity and die from cancer. Primary prevention through elimination of risk factors such as smoking and poor nutrition is the most effective way to reduce the burden of cancer. Secondary prevention, the early detection of cancer at its most treatable stage, can also be effective for selected cancers. The remainder of this report reviews recent progress and current opportunities for primary and secondary prevention of cancer in the United States.