National Academies Press: OpenBook
Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2003. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: The National Academies Press. doi: 10.17226/10263.
×

Fulfilling the Potential of Cancer Prevention and Early Detection

Susan J. Curry, Tim Byers, and Maria Hewitt, Editors

National Cancer Policy Board

INSTITUTE OF MEDICINE

NATIONAL RESEARCH COUNCIL OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS
Washington, D.C.
www.nap.edu

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2003. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: The National Academies Press. doi: 10.17226/10263.
×

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.

Support for this project was provided by the National Cancer Institute; the Centers for Disease Control and Prevention; the American Cancer Society; Abbott Laboratories; the American Society of Clinical Oncology; Amgen, Inc.; Aventis; and the United Health Care Foundation. The views presented in this report are those of the Institute of Medicine and the National Research Council National Cancer Policy Board and are not necessarily those of the funding agencies.

Library of Congress Cataloging-in-Publication Data

Fulfilling the potential of cancer prevention and early detection / Susan J. Curry, Tim Byers, and Maria Hewitt, editors ; National Cancer Policy Board.

p. ; cm.

Includes bibliographical references and index.

ISBN 0-309-08254-4 (hardcover)

ISBN 0-309-50619-0 (PDF Full Book)

1. Cancer—United States—Prevention.

[DNLM: 1. Neoplasms—prevention & control—United States. 2. Health Behavior—United States. 3. Health Policy—United States. 4. Health Promotion—methods—United States. 5. Mass Screening—United States. QZ 200 F962 2003] I. Curry, Susan J. II. Byers, Tim. III. Hewitt, Maria Elizabeth. IV. National Cancer Policy Board (U.S.)

RC268.F85 2003

616.99’4052—dc21

2003000742

Additional copies of this report are available from the
National Academies Press,
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For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu.

Copyright 2003 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America.

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2003. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: The National Academies Press. doi: 10.17226/10263.
×

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

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2003. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: The National Academies Press. doi: 10.17226/10263.
×

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

DIANA PETITTI (Vice Chair), Director,

Research & Evaluation, Kaiser Permanente of Southern California, Pasadena, CA

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

TIM BYERS, Professor of Epidemiology, Program Leader,

Clinical Cancer Prevention & Control, University of Colorado Health Sciences Center, Denver, CO

VIVIEN W. CHEN, Epidemiology Section Chief & Professor,

Louisiana State University Medical Center, New Orleans, LA (member through March 2002)

SUSAN CURRY, Professor, Health Policy and Administration, and Director,

Health Research and Policy Centers, University of Illinois at Chicago, Chicago, IL (member through March 2002)

TIMOTHY EBERLEIN, Bixby Professor and Chairman,

Department of Surgery, Washington University School of Medicine, St. Louis, MO

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

DANIEL J. KEVLES, Professor,

Yale University, New Haven, CT

WILLIAM MCGUIRE, Chief Executive Officer,

UnitedHealth Group, Minnetonka, Minnesota

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

MONICA MORROW, Professor of Surgery,

Comprehensive Breast Program, Northwestern University, Chicago, IL (member through March 2002)

NANCY MUELLER, Professor of Epidemiology,

Harvard School of Public Health, Department of Epidemiology, Boston, MA

PATRICIA NOLAN, Director,

Rhode Island Department of Health, Providence, RI

PILAR OSSORIO, Assistant Professor of Law & Medical Ethics, Associate Director for Programming,

Center for the Study of Race and Ethnicity in Medicine, University of Wisconsin Law School, Madison, WI (member through March 2002)

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2003. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: The National Academies Press. doi: 10.17226/10263.
×

CECIL B. PICKETT, Executive Vice President,

Discovery Research, Schering-Plough Research Institute, Kenilworth, NJ

LOUISE RUSSELL, Professor,

Rutgers University, New Brunswick, NJ

JOHN SEFFRIN, Chief Executive Officer,

American Cancer Society, Atlanta, GA (member through March 2002)

THOMAS J. SMITH, Professor,

Virginia Commonwealth University, Richmond, VA

SANDRA UNDERWOOD, ACS Oncology Nursing Professor,

University of Wisconsin School of Nursing, Milwaukee, WI (member through March 2002)

SUSAN WEINER, President,

The Children’s Cause, Silver Spring, MD

ROBERT C. YOUNG, President,

American Cancer Society and the Fox Chase Cancer Center, Philadelphia, PA

Consultants

Graham A. Colditz, Catherine Tomeo Ryan, Charles H. Dart, III, Geetanjali Datta, Laurie Fisher, and Beverly Rockhill,

Channing Laboratory, Boston, MA

Steven H. Woolf,

Department of Family Practice, Virginia Commonwealth University

Parthiv J. Mahadevia, Farin Kamangar, and Jonathan M. Samet,

Bloomberg School of Public Health, Johns Hopkins University

Edwin B. Fisher and Mario Schootman,

Washington University School of Medicine, and

Ross C. Brownson, Amy A. Eyler, and Debra L. Haire-Joshu,

St. Louis University

Judith Ockene, Jane Zapka, Lori Pbert, Suzanne Brodney, and Stephenie Lemon,

University of Massachusetts Medical School

Suzanne Phelan and Rena R. Wing,

Weight Control and Diabetes Research Center, Brown University

Study Staff

Maria Hewitt, Study Director

Mary Joy Ballantyne, Research Assistant

Gelsey Lynn, Research Assistant

Timothy K. Brennan, Research Assistant

Michael K. Hayes, Editor

NCPB Staff

Roger Herdman, Director,

National Cancer Policy Board

Nicci T. Dowd, Administrator

Jennifer Cangco, Financial Associate

Rosa Pommier, Financial Associate

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2003. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: The National Academies Press. doi: 10.17226/10263.
×

REVIEWERS

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:

Timothy B. Baker, University of Wisconsin, Madison

Dileep G. Bal, Cancer Control Branch, California Department of Health, Sacramento, CA

Moon S. Chen, Jr., Ohio State University, Dublin, OH

Wendy Demark-Wahnefried, Duke University Medical Center, Durham, NC

Paul Frame, Tri-County Family Medicine, Cohoctin, NY

Carolyn Gotay, Cancer Research Center of Hawaii, Honolulu

Kathy Helzlsouer, Bloomberg School of Public Health, Johns Hopkins University

Arthur Levin, Center for Medical Consumers, New York, NY

Anne McTiernan, Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, WA

Duncan B. Neuhauser, Department of Epidemiology & Biostatistics, Case Western Reserve University Medical School, Cleveland, OH

Malcom C. Pike, USC/Norris Cancer Center, Los Angeles, CA

Helen Halpin Schauffler, Center for Health and Public Policy Studies, University of California, Berkeley

David Schottenfeld, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI

Steve Taplin, Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, WA

Beti Thompson, Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, WA

Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by Maureen M. Henderson,

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2003. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: The National Academies Press. doi: 10.17226/10263.
×

M.D., D.P.H., Professor Emeritus of Epidemiology and Medicine, University of Washington. Appointed by the National Research Council, she was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.

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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2003. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: The National Academies Press. doi: 10.17226/10263.
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Acknowledgments

The National Cancer Policy Board first and foremost acknowledges the contribution of the Board’s prevention subgroup. These Board members provided leadership and spent many hours shaping the study plan, reviewing drafts, discussing recommendations, and offering assistance to staff throughout the report’s production.

Board Prevention Subgroup

  • Susan Curry, (Group leader), University of Illinois at Chicago

  • Diana Petitti, (Board Vice Chair), Kaiser Permanente of Southern California

  • Tim Byers, University of Colorado Health Sciences Center

  • Vivien W. Chen, Louisiana State University Medical Center

  • William McGuire, UnitedHealth Group

  • Nancy Mueller, Harvard School of Public Health

  • Louise Russell, Rutgers University

  • John Seffrin, American Cancer Society

  • Sandra Underwood, University of Wisconsin School of Nursing

Former Board members Robert Day, Fred Hutchinson Cancer Research Center, and Ellen Gritz, M.D. Anderson Cancer Center, helped plan the report.

The Board also acknowledges the tremendous contribution made by authors of background papers that formed the basis of several of the report’s chapters.

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2003. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: The National Academies Press. doi: 10.17226/10263.
×
  • Graham A. Colditz and his colleagues Catherine Tomeo Ryan, Charles H. Dart, III, Geetanjali Datta, Laurie Fisher, and Beverly Rockhill wrote “Quantifying the Contribution of Risk Factors to Cancer Incidence and the Estimated Reduction in Cancer Burden Through Selected Risk Factor Modifications.”

  • Edwin B. Fisher and his colleagues Ross C. Brownson, Amy A. Eyler, Debra L. Haire-Joshu, and Mario Schootman wrote “Interventions to Promote Key Behaviors in Cancer Prevention and Early Detection.”

  • Parthiv J. Mahadevia, Farin Kamangar, and Jonathan M. Samet wrote “Fulfilling the Potential of Lung Cancer Prevention and Early Detection: What Are the Implications of Adopting New Technologies in the Face of Uncertain Science?

  • Judith Ockene and her colleagues Jane Zapka, Lori Pbert, Suzanne Brodney, and Stephenie Lemon wrote “Provider, System, and Policy Strategies to Enhance the Delivery of Cancer Prevention and Control Activities in Primary Care.”

  • Suzanne Phelan and Rena R. Wing wrote “Interventions to Reduce Obesity and Maintain a Healthy Weight.”

  • Steven H. Woolf wrote “The Effectiveness of Screening for Cancer and Its Unfulfilled Potential in the United States: A Review of the Evidence.”

Several other individuals addressed the Board at their quarterly meetings providing important information and perspectives:

  • Ralph Coates and Kevin Brady, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention

  • Barbara Rimer and Robert Croyle, Division of Cancer Control and Population Sciences, National Cancer Institute (NCI)

Several individuals met with or corresponded with Board staff to provide information about their programs and activities.

  • Carol Ashton, Houston Veterans Administration Center for Quality of Care and Utilization Studies

  • Kevin Brady, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention

  • Mary Burdick, Veterans Administration National Center for Health Promotion and Disease Prevention (NCHPDP)

  • Leslie Given, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention

  • Peter Greenwald, Division of Cancer Prevention, NCI

  • Brian Kimes, Office of Centers, Training, and Resources, NCI

  • Wendy Perry, Office of the Director, Agency for Healthcare Research and Quality

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2003. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: The National Academies Press. doi: 10.17226/10263.
×
  • Stacey Vandor, Office of the Director, Division of Cancer Control and Population Sciences, NCI

Many individuals made important contributions by reviewing sections of the report for accuracy

  • Jean K. Brown, University at Buffalo School of Nursing, State University of New York

  • Sachiko St. Jeor, Nutrition Education and Research Program, University of Nevada

  • Helen Meissner, Applied Cancer Screening Research Branch, Behavioral Research Program, DCCPS, NCI

  • John D. Potter, Fred Hutchinson Cancer Research Center

  • Linda Meyers and Paula Trumbo, Food and Nutrition Board, Institute of Medicine

  • Nancy Riese Daly, American Society for Therapeutic Radiology and Oncology (ASTRO)

  • William T. Sause, Department of Radiation Oncology, LDS Hospital, Salt Lake City, Utah

  • Michael Whitcomb, Division of Medical Education, Association of American Medical Colleges

The Board also wishes to thank David Berrigan, NCI Cancer Prevention Fellow, who followed the progress of the report and reviewed commissioned papers and report drafts.

The Board thanks high school students Ben Markwell and Alex Del Pinal for their contribution in checking references.

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2003. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: The National Academies Press. doi: 10.17226/10263.
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Acronyms and Abbreviations


AACE

American Association for Cancer Education

AAHP

American Association of Health Plans

AAMC

Association of American Medical Colleges

ACRIN

American College of Radiology Imaging Network

ACS

American Cancer Society

ACSM

American College of Sports Medicine

ACT

Activity Counseling Trial

AHCPR

Agency for Health Care Policy and Research

AHEC

Area Health Education Center

AHRQ

Agency for Healthcare Research and Quality

ALA

American Lung Association

ASPO

American Society of Preventive Oncology

ATBC

Alpha-Tocopherol Beta-Carotene Cancer Prevention Study Group

ATPM

Association of Teachers of Preventive Medicine


BED

binge eating disorder

BMI

body mass index

BPHC

Bureau of Primary Health Care (HRSA)


CAD

computer-aided diagnosis

CARET

Beta-Carotene and Retinol Efficacy Trial

CATCH

Child and Adolescent Trial for Cardiovascular Health

CDC

Centers for Disease Control and Prevention

CDMRP

Congressionally Directed Medical Research Programs

CHC

Community Health Center Program

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2003. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: The National Academies Press. doi: 10.17226/10263.
×

CI

confidence interval

CME

continuing medical education

CMS

Centers for Medicare and Medicaid Services (formerly the Health Care Financing Administration)

CONQUEST

Computerized Needs-Oriented Quality Measurement Evaluation System

CQI

continuous quality improvement

CSP

Cooperative Studies Program (VA)

CT

computed tomography


DCCPS

Division of Cancer Control and Population Sciences (NCI)

DCIS

ductal carcinoma in situ

DHHS

U.S. Department of Health and Human Services

DoD

U.S. Department of Defense


ELCAP

Early Lung Cancer Action Project


FDA

Food and Drug Administration

FFS

fee for service

FOBT

fecal occult blood test

FQHC

federally qualified health centers

FY

fiscal year


GM

General Motors


HCFA

Health Care Financing Administration (now the Centers for Medicare and Medicaid Services)

HEDIS

Health Plan Employer Data and Information Set

HMO

health maintenance organization

HPV

human papillomavirus

HRA

health risk appraisal

HRSA

Health Resources and Services Administration


IARC

International Agency for Research on Cancer

IHS

Indian Health Service

IOM

Institute of Medicine


kcal/day

kilocalories per day

kg

kilogram

kg/m2

kilogram per square meter


lb

pound (1 pound = 0.45 kilogram)

LCD

low-calorie diet


mA

milliangstroms

MCO

managed care organization

mg

milligram

MHC

Migrant Health Center Program

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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2003. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: The National Academies Press. doi: 10.17226/10263.
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mm

millimeter

mrad

millirad

MTCP

Massachusetts Tobacco Control Program


NBCCEDP

National Breast and Cervical Cancer Early Detection Program

NCI

National Cancer Institute

NDC

National Dialogue on Cancer

ng/dl

nanograms per deciliter

NHANES

National Health and Nutrition Examination Survey

NHLBI

National Heart, Lung, and Blood Institute

NIH

National Institutes of Health

NNS

number needed to screen

NNT

number needed to treat

NRT

nicotine replacement therapy

NSAID

nonsteroidal anti-inflammatory drug

NTAO

National Technical Assistance Office


OTC

over the counter (nonprescription)


PACE

Physician-Based Assessment and Counseling for Exercise

PBGH

Pacific Business Group on Health

PCAP

Prevention Curriculum Assistance Program

PDQ

Physician Data Query

PLCO

study Prostate, Lung, Colorectal, and Ovarian study

PPIP

Put Prevention into Practice

PPV

positive predictive value

PSA

prostate-specific antigen


QALY

quality-adjusted life year

QUERI

Quality Enhancement Research Initiative

QuIC

Quality Interagency Coordination


RADIUS

Research and Development in the United States (database)

RWJF

Robert Wood Johnson Foundation


SCHIP

State Children’s Health Insurance Program

SEER

Surveillance, Epidemiology, and End Results Program

SPN

Special Populations Networks for Cancer Awareness, Research, and Training


TRCBSs

Translational Research Centers in Behavioral Science

TRIP

Translating Research into Practice


USPSTF

U.S. Preventive Services Task Force


VA

U.S. Department of Veterans Affairs

VANAC

VA Nurses Against Cancer

VBG

vertical banded gastroplasty

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2003. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: The National Academies Press. doi: 10.17226/10263.
×

VHA

Veterans Health Administration

VISN

Veterans Integrated Service Networks

VLCD

very low-calorie diet


WHO

World Health Organization

WIC

Special Supplemental Food Program for Women, Infants, and Children

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2003. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: The National Academies Press. doi: 10.17226/10263.
×

List of Boxes, Figures, and Tables

BOXES

3.1

 

Definition of Levels of Evidence for Epidemiological Associations,

 

42

3.2

 

Frequently Referenced Prospective Cohort Studies,

 

43

4.1

 

Core Components of Skill-Training Interventions,

 

93

4.2

 

Selected State Tobacco Control Initiatives,

 

103

4.3

 

A Model Tobacco Control Program in an HMO,

 

154

5.1

 

Definitions of Screening Test Performance,

 

159

5.2

 

Hierarchy of Effectiveness of Study Designs,

 

164

5.3

 

Recommendations for Colorectal Cancer Screening in Average-Risk Persons,

 

184

5.4

 

Recommendations for Screening for Breast Cancer,

 

203

5.5

 

Recommendations for Screening for Prostate Cancer,

 

216

5.6

 

Recommendations for Screening for Cervical Cancer,

 

221

6.1

 

Challenges to Providers in Improving Rates of Screening for Colorectal Cancer,

 

234

6.2

 

Cancer Screening at Worksites and Places of Worship,

 

247

8.1

 

Selected Healthy People 2010 Cancer Objectives,

 

298

8.2

 

Professional Organizations with a Focus on Health Promotion and Disease Prevention,

 

302

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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2003. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: The National Academies Press. doi: 10.17226/10263.
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8.3

 

Recommended Content Areas for a Smoking and Tobacco Use Cessation Intervention Curriculum,

 

308

8.4

 

Examples of State Efforts to Train Smoking and Tobacco Use Treatment Providers,

 

318

9.1

 

Cancer-Related Healthy People 2010 Objectives,

 

333

9.2

 

Surgeon General’s Reports on Tobacco Control,

 

337

9.3

 

Selected Examples of Cancer Prevention and Early Detection Surveillance Tools,

 

337

9.4

 

State-Level Variations in Cancer Risk Factors,

 

339

9.5

 

VHA National Cancer Strategy Policy Objectives,

 

345

10.1

 

Evolving Definition of Cancer Control Research,

 

366

10.2

 

Objectives of NCI Strategic Plan to Reduce Health Disparities,

 

378

10.3

 

Cochrane Reviews Related to Cancer Prevention and Early Detection,

 

397

11.1

 

Interventions Recognized as Effective Against Smoking and Promoted by National Organizations,

 

408

11.2

 

Summary of Objectives to Reduce Illness, Disability, and Death Related to Tobacco Use and Exposure to Secondhand Smoke Outlined in Healthy People 2010,

 

413

11.3

 

Recommendations for Public Health Action on Weight Control and Physical Activity to Promote Cancer Prevention, IARC, WHO,

 

414

11.4

 

Public Health’s Mission and Services,

 

419

FIGURES

1.1

 

Age-Adjusted Cancer Death Rates,* for Males by Site, U.S. 1930– 1997,

 

19

1.2

 

Age-Adjusted Cancer Death Rates,* for Females by Site, U.S. 1930– 1997,

 

20

3.1

 

Age-Adjusted Prevalence of Overweight (BMI 25–29 kg/m2) and Obesity (BMI = 30 kg/m2) in U.S. Adults Aged 20–74,

 

64

3.2

 

Age-Adjusted Prevalence of Overweight or Obesity (BMI = 25 kg/ m2) by Sex and Race/Ethnicity,

 

65

9.1

 

Comprehensive Cancer Control Plans, 2001,

 

340

10.1

 

PubMed Citations for Cancer-Related Prevention and Control Research, 1985–2000,

 

369

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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2003. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: The National Academies Press. doi: 10.17226/10263.
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10.2

 

PubMed Citations for Cancer-Related Prevention and Control Research as a Percentage of All Cancer-Related Citations, 1985– 2000,

 

369

10.3

 

Organizational Chart for NCI’s DCCPS,

 

376

10.4

 

Distribution of Research Dollars (not the number of grants) Spent in DCCPS Behavioral Research Portfolio, FY 2001 (total amount, $113.5 million),

 

377

11.1

 

Cigarette Smoking, United States, 1990–1999,

 

404

11.2

 

Prevalence of Overweight Among Children and Adolescents: United States, 1963–1970 to 1999–2000,

 

406

TABLES

1.1

 

Deaths and Percent of Total Deaths for Leading Causes of Death by Sex: United States, 1999,

 

18

1.2

 

Estimated Number of New Cancer Cases and Cancer Deaths in the United States, 2002,

 

21

1.3

 

Incidence and Mortality Rates by Site, Race, and Ethnicity, United States, 1992–1998,

 

23

1.4

 

Five-Year Relative Survival Rates, by Racial or Ethnic Group and Stage at Diagnosis, United States, 1989–1996,

 

24

2.1

 

Risk Factors, Goals, and Assumptions Used by NCI Working Group and ACS in Predictions for the United States,

 

34

3.1

 

Increase in Risk of Incident Cancer Associated with Smoking,

 

44

3.2

 

Current Cigarette Use, Adults 18 Years or Older, United States, 1999,

 

55

3.3

 

Tobacco Use, High School Students, United States, 1999,

 

56

3.4

 

Reduction in Risk of Incident Cancer Associated with Physical Activity,

 

58

3.5

 

Increase in Risk of Incident Cancer Associated with Obesity,

 

61

3.6

 

Reduction in Risk of Incident Cancer Associated with Fruit and Vegetable Intake,

 

67

3.7

 

Increase in Risk of Incident Cancer Associated with High Intakes of Red Meat,

 

73

3.8

 

Risk of Incident Cancer Associated with Selected Macronutrients,

 

78

3.9

 

Risk of Incident Cancer Associated with Selected Micronutrients,

 

79

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2003. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: The National Academies Press. doi: 10.17226/10263.
×

3.10

 

Increase in Risk of Incident Cancer Associated with Alcohol Use,

 

83

4.1

 

Summary of Treating Tobacco Uses and Dependence (TTUD) Meta-Analysis Assessing the Impact of Various Elements of Treatment Structure,

 

95

4.2

 

Summary of TTUD Meta-Analyses Evaluating First-Line Pharmacotherapies,

 

100

4.3

 

Access to Wellness Programs and Fitness Centers Among U.S. Full-Time Employees, by Type of Employer,

 

116

4.4

 

Summary of AHRQ Analyses of the Efficacy of Interventions to Modify Dietary Behavior Related to Cancer Risk: Fruit and Vegetable Intake,

 

140

4.5

 

Summary of AHRQ Analyses of the Efficacy of Interventions to Modify Dietary Behavior Related to Cancer Risk: Dietary Fat Intake (percentage of energy from fat),

 

141

5.1

 

Illustration of Influence of Prevalence on Positive Predictive Value,

 

160

5.2

 

Randomized Controlled Trials of Fecal Occult Blood Testing,

 

177

5.3

 

Results of the Randomized Clinical Trials of Screening Mammography,

 

189

7.1

 

Summary of Nonrandomized Prospective Trials of Lung Cancer Screening (1950s to 1970s),

 

262

7.2

 

First Screening (Prevalence) Results from NCI-Sponsored Randomized Controlled Trials of Lung Cancer Screening Using Chest Radiographs and Sputum Cytology,

 

266

7.3

 

Incidence Screening Results from Randomized Controlled Trials of Lung Cancer Screening Using Chest Radiographs and Sputum Cytology,

 

268

7.4

 

Spiral CT Lung Cancer Screening Trials: Prevalence Data,

 

278

7.5

 

Spiral CT Lung Cancer Screening Trials: Incidence Data,

 

280

8.1

 

National Cancer Institute Research Training and Career Development Opportunities for Prevention, Control, Behavioral, and Population Scientists,

 

323

8.2

 

Training and Career Development Opportunities, American Cancer Society,

 

329

9.1

 

VHA Cancer-Related Behavioral Risk Factor Counseling Recommendations,

 

345

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2003. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: The National Academies Press. doi: 10.17226/10263.
×

9.2

 

VHA Cancer Screening Recommendations,

 

346

9.3

 

Preventive Health Practices, Veterans Health Survey, 1997– 1999,

 

347

9.4

 

Preventive Health Practices, Results of Chart Audit, External Peer Review Program, 1999,

 

348

9.5

 

Percentage (95% confidence interval) of Reproductive-Age Women Reporting Pap Testing in the Past Year, by Location of Test and Health Insurance Coverage, National Survey of Family Growth, 1995,

 

353

9.6

 

Coverage for Cancer Screening Tests Under Original Medicare Plan, Centers for Medicare and Medicaid Services,

 

356

9.7

 

Mammography Use Within Past 2 Years,

 

357

9.8

 

Medicare Beneficiaries’ Rates of Use (Percent) of Tests for Colorectal Cancer Screening and Diagnostic Services, 1995–1999,

 

359

9.9

 

Medicaid Program Coverage of Pharmacotherapy and Counseling, United States, 2000,

 

362

10.1

 

Types of Research Necessary to Improve the Application of Evidence-Based Cancer Prevention and Early Detection Interventions,

 

367

10.2

 

Distribution of Cancer Control and Population Sciences Grants Funded in FY 2001, by Program,

 

377

10.3

 

Centers for Disease Control and Prevention FY 2001 Appropriation,

 

382

10.4

 

AHRQ-Supported Research Grants, FYs 1999 to 2001,

 

385

10.5

 

Congressionally Directed Medical Research Programs of the U.S. Department of Defense,

 

390

10.6

 

VA-Supported Cancer Prevention and Early Detection Research at VA Centers of Excellence,

 

392

10.7

 

ACS Research Funding (Intramural and Extramural), FYs 1999 to 2000,

 

393

10.8

 

Other Selected Foundations Supporting Cancer Prevention and Early Detection Research,

 

395

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2003. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: The National Academies Press. doi: 10.17226/10263.
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Fulfilling the Potential of Cancer Prevention and Early Detection

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Fulfilling the Potential of Cancer Prevention and Early Detection Get This Book
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Cancer ranks second only to heart disease as a leading cause of death in the United States, making it a tremendous burden in years of life lost, patient suffering, and economic costs. Fulfilling the Potential for Cancer Prevention and Early Detection reviews the proof that we can dramatically reduce cancer rates. The National Cancer Policy Board, part of the Institute of Medicine, outlines a national strategy to realize the promise of cancer prevention and early detection, including specific and wide-ranging recommendations. Offering a wealth of information and directly addressing major controversies, the book includes:

• A detailed look at how significantly cancer could be reduced through lifestyle changes, evaluating approaches used to alter eating, smoking, and exercise habits.

• An analysis of the intuitive notion that screening for cancer leads to improved health outcomes, including a discussion of screening methods, potential risks, and current recommendations.

• An examination of cancer prevention and control opportunities in primary health care delivery settings, including a review of interventions aimed at improving provider performance.

• Reviews of professional education and training programs, research trends and opportunities, and federal programs that support cancer prevention and early detection.

This in-depth volume will be of interest to policy analysts, cancer and public health specialists, health care administrators and providers, researchers, insurers, medical journalists, and patient advocates.

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