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Fulfilling the Potential of Cancer Prevention and Early Detection

An American Cancer Society and Institute of Medicine Symposium

Roger Herdman and Leonard Lichtenfeld, Editors

National Cancer Policy Board

INSTITUTE OF MEDICINE and

NATIONAL RESEARCH COUNCIL



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Fulfilling the Potential of Cancer Prevention and Early Detection: An American Cancer Society and Institute of Medicine Symposium Fulfilling the Potential of Cancer Prevention and Early Detection An American Cancer Society and Institute of Medicine Symposium Roger Herdman and Leonard Lichtenfeld, Editors National Cancer Policy Board INSTITUTE OF MEDICINE and NATIONAL RESEARCH COUNCIL

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Fulfilling the Potential of Cancer Prevention and Early Detection: An American Cancer Society and Institute of Medicine Symposium THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This study was supported by Contract No. NO2-CO-01029 between the National Academy of Sciences and the National Cancer Institute and by a grant from the American Cancer Society. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the organizations or agencies that provided support for the project. International Standard Book Number 0-309-09171-3 (Book) International Standard Book Number 0-309-53086-5 (PDF) Additional copies of this report are available from the National Academies Press, 500 Fifth Street, N.W., Lockbox 285, Washington, DC 20055; (800) 624–6242 or (202) 334–3313 (in the Washington metropolitan area); Internet, http://www.nap.edu. For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu. Copyright 2004 by the National Academy of Sciences. All rights reserved. Printed in the United States of America.

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Fulfilling the Potential of Cancer Prevention and Early Detection: An American Cancer Society and Institute of Medicine Symposium THE NATIONAL ACADEMIES Advisers to the Nation on Science, Engineering, and Medicine The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M.Alberts is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Wm. A.Wulf is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V.Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M.Alberts and Dr. Wm. A.Wulf are chair and vice chair, respectively, of the National Research Council. www.national-academies.org

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Fulfilling the Potential of Cancer Prevention and Early Detection: An American Cancer Society and Institute of Medicine Symposium NATIONAL CANCER POLICY BOARD JOSEPH SIMONE (Chair), Simone Consulting , Dunwoody, GA ELLEN STOVALL (Vice Chair), Executive Director, National Coalition for Cancer Survivorship, Silver Spring, MD BRUCE W.STILLMAN (Vice Chair), Director, Cold Spring Harbor Laboratory, Cold Spring Harbor, NY JILL BARGONETTI, Associate Professor, Department of Biological Sciences, Hunter College, New York, NY TIMOTHY EBERLEIN, Bixby Professor and Chairman, Department of Surgery, Washington University School of Medicine, St. Louis, MO KATHY GIUSTI, President, Multiple Myeloma Research Foundation, New Cannaan, CT KAREN HERSEY, Senior Counsel, Massachusetts Institute of Technology, Cambridge, MA JIMMIE C.HOLLAND, Chair, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY WILLIAM KAELIN, Professor, Harvard Medical School, Boston, MA WILLIAM McGUIRE, Chief Executive Officer, UnitedHealth Group, Minnetonka, MN JOHN MENDELSOHN, President, M.D. Anderson Cancer Center, University of Texas, Houston, TX KATHLEEN HARDIN MOONEY, Professor, University of Utah College of Nursing, Salt Lake City, UT PATRICIA NOLAN, Director, Rhode Island Department of Health, Providence, RI DAVID PARKINSON, Oncology Therapeutic Head, Amgen, Inc., Thousand Oaks, CA JOHN POTTER, Senior Vice President and Director, Cancer Prevention Research Program, Fred Hutdchinson Cancer Research Center, Seattle, WA LOUISE RUSSELL, Professor of Economics, Rutgers University, New Brunswick, NJ THOMAS J.SMITH, Professor of Medicine, Virginia Commonwealth University, Richmond, VA EDWARD WAGNER, Director W.A. (Sandy) MacColl Institute for Healthcare Innovation, Group Health Cooperative, Seattle, WA ROBERT C.YOUNG, Past-President, American Cancer Society and President, Fox Chase Cancer Center, Philadelphia, PA

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Fulfilling the Potential of Cancer Prevention and Early Detection: An American Cancer Society and Institute of Medicine Symposium NCPB Study Staff Roger Herdman, Study Director Timothy Brennan, Research Assistant ACS Study Staff Leonard Lichtenfeld NCPB Staff Roger Herdman, Director, National Cancer Policy Board Anike Johnson, Administrator Rosa Pommier, Financial Associate

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Fulfilling the Potential of Cancer Prevention and Early Detection: An American Cancer Society and Institute of Medicine Symposium Contents     ABSTRACT   1     INTRODUCTION   3     PLENARY SESSION   6     GROUP DISCUSSIONS   66     WRAP-UP SESSION   115     REFERENCES   120     APPENDIX: SYMPOSIUM AGENDA   123

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