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Suggested Citation:"Index." 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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Index*

A

Access to services, 152

distribution of cancer burden and, 8, 12–13, 22, 425, 433–434

obstacles to cancer screening participation, 225, 231–232, 243, 410, 436

recommendations for improving, 7, 8, 423–424, 425

Adenomatous polyps, 59, 175

Advertising of tobacco products, 4, 412

Agency for Healthcare Policy and Research, 99, 105

Agency for Healthcare Research and Quality, 10, 218, 334, 335

clinician training programs, 328

Evidence-Based Practice Centers, 384

guidelines development and dissemination, 384–387

Preventive Services Task Force, 10–11, 228, 275, 333–334, 387, 428– 430

Quality Interagency Coordination Task Force, 388

recommendations for, 10–11, 12, 428

research activities, 384–388

Task Force on Community Preventive Services, 334, 428, 429, 430

Translating Research into Practice, 387

weight-loss program evaluations, 139, 140t, 141t, 142, 143, 144

Aging of population, 10, 428

cancer risk, 22

implications for provider education and training, 296

See also Elderly patients

Alcohol consumption

alcohol types, 82–83

associated cancer risk, 82–83, 83t

breast cancer and, 84

cancer risk and, 86, 403

carcinogenic action, 83–84

colorectal cancer and, 84–85

health effects, 81–82

liver cancer and, 84

lung cancer and, 85

oropharyngeal/laryngeal/esophageal cancer risk, 83–84

potential effectiveness of cancer prevention, 1, 36, 400–401

predictive modeling of cancer reduction, 32–33

sociodemographic patterns, 85

tobacco use and, 47, 83

*  

Page numbers followed by t refer to tables. Page numbers followed by f refer to figures.

Suggested Citation:"Index." 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.
×

Alliance, The, 422–423

Alpha-Tocopherol Beta Carotene Cancer Prevention Study Group, 79–80

American Academy of Family Physicians, 215

American Association for Cancer Education, 302f, 306

American Association of Health Plans, 329– 330

American Association of Medical Colleges, 301–303, 302f, 304–305

American Cancer Society, 13, 183, 306, 421

Cancer Prevention Studies, 43f, 45–46, 50, 52–53, 54

cancer reduction goals, 33, 34–35t

clinician training programs, 328–329

research programs, 392, 399

screening guidelines, 228, 274–275

American College of Physicians, 215

American College of Radiology, 286–287, 288

American Gastroenterological Association, 183

American Legacy Foundation, 330, 394– 395

American Lung Association, 97, 317

American Society of Preventive Oncology, 302–303f

American Urological Association, 215

Anti-Lung Cancer Action, 277, 283

Association of American Medical Colleges, 426

Association of Teachers of Preventive Medicine, 302f, 303, 305

B

Barium enema, 179

Behavioral interventions

conceptual models of change processes, 89–92

effectiveness, 2, 87, 153–155, 407

health care system implementation, 148– 153

to improve eating habits, 138–145

to improve physical activity, 111, 113– 120

to improve screening participation, 244– 250

incentive programs, 132

latency of effects, 39

predictive modeling, 32–33, 37, 38

public education campaigns, 11–12, 432

risk factor counseling, 345t

service delivery strategies, 87–89

smoking cessation programs, 93–101

target behaviors, 2n, 17, 401

weight-loss programs, 127–129

Behavioral Risk Factor Surveillance System, 57

Benzene, 52

Beta-carotene, 69, 79–80

Bladder cancer, 44, 47–48, 54

fruit and vegetable consumption and, 68–69

Body mass index, 65–66

Breast biopsy, 197

Breast cancer

alcohol consumption and, 84

carotenoid consumption and, 79

clinician education for early detection, 324–325

dietary fat intake and, 77

epidemiology, 25, 26

fruit and vegetable consumption and, 69

incidence, 19

obesity and, 62, 402

physical activity and, 58, 60, 402

potential effectiveness of preventive intervention, 1, 36, 37

quality of preventive services, 9

risk factors, 25–26

screening, 6, 7, 37, 158, 351–352, 403, 424

breast self-examination, 195–196

clinical breast examination, 186–187

cost-effectiveness, 198–199

DCIS detection, 186

effectiveness of early detection, 188– 194

genetic, 195, 197–198

insurance coverage, 6, 421

mammography, 403

Medicare coverage, 355

modalities, 186–187

for older women, 194

potential harms, 196–198

practice guidelines, 203–204f, 223

public awareness and understanding, 240–241, 242–243, 245, 246

strategies for improving, 244–250

subjective value judgments in, 199– 203

utilization, 225–226, 238–239

selenium intake and, 80

Suggested Citation:"Index." 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.
×

British male doctors study, 43f, 46, 47

Bronchoscopy, 285–286

Bupropion, 98–100

C

Calcium, 76

Canadian Breast Cancer Screening Initiative, 187, 192–193

Cancer Intervention and Surveillance Modeling Network, 38–39

Carbohydrates, 77

weight-loss programs, 122, 123–124

Cardiovascular disease, 17

diet and, 66

obesity and, 61, 66

physical activity and, 58, 114

physical activity regimen to prevent, 111

Cardiovascular Health in Children, 143– 144

Carotenoids, 50, 69, 71, 79–80

Case finding, 156

Case management, 250

CATCH. See Child and Adolescent Trial for Cardiovascular Health

Causes of cancer, 27–28, 31–32, 401–403

bladder cancer, 47–48

breast cancer, 58, 60, 62, 84, 402

cervical cancer, 51

colon cancer, 49–50, 59–60, 63

colorectal cancer, 58, 62, 72–73, 78–79, 84–85

endometrial cancer, 53, 62, 402

esophageal cancer, 64, 67, 402

kidney cancer, 48, 63, 74, 402

laryngeal cancer, 67

leukemia, 52

liver cancer, 52, 84

lung cancer, 45, 401

obesity, 61–64, 402

oropharyngeal cancer, 46–47, 67, 83–84

pancreatic cancer, 49, 74

prostate cancer, 53, 62, 73–74

red meat consumption, 72–74

stomach cancer, 50, 67–68

See also Lifestyle factors;

Smoking-related cancer

Centers for Disease Control and Prevention, 3, 10, 11, 256, 334, 435

budget, 381, 382t, 398–399

cancer screening programs, 7–8, 351– 352, 424

Center for Chronic Disease Prevention and Health Promotion, 418

clinician education programs, 324–326

data collection activities, 337–338

information dissemination activities, 336

Office of Smoking and Health, 418

recommendations for, 5, 7–8, 410–411, 418–419, 424

research activities, 381–384, 398–399

school diet and nutrition guidelines, 417

state programs, 338–340, 341, 418–419

Centers for Medicare and Medicaid Services, 9, 256, 388–390, 425

See also Medicaid;

Medicare

Cervical cancer, 350–351

clinician education for early detection, 324–325

epidemiology, 27

fruit and vegetable consumption and, 71–72

mortality, 27

potential effectiveness of preventive intervention, 1, 403

risk factors, 51, 421

screening, 6, 7, 158, 171, 218–220, 221f, 223, 253–255, 351, 403

smoking-related, 44, 51

Chemoprevention, 17

Child and Adolescent Trial for Cardiovascular Health (CATCH), 117, 137, 144

Church-based programs, 119, 147, 247f

Clonidine, 98

Cochrane Collaboration, 190, 229, 395– 396, 397f

Cognitive functioning

medical attitudes and beliefs, 230–231, 241

models of behavior change, 89–92

Colonoscopy, 179–180, 181, 182, 183–185, 233, 234, 237

Colorectal cancer

alcohol consumption and, 84–85

clinician education for early detection, 325–326

epidemiology, 26–27

folate intake and, 78–79

fruit and vegetable consumption and, 69–70

glucose metabolism and, 80–81

incidence, 19

obesity and, 62, 63, 402

Suggested Citation:"Index." 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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physical activity and, 58, 59–60

potential effectiveness of preventive intervention, 1, 36, 37

public awareness and understanding, 235, 236

red meat consumption and, 72–73

risk factors, 27, 175

screening, 6, 7–8, 11, 223, 226, 359t, 403, 421, 424, 429

effectiveness, 175

fecal occult blood testing, 176–177, 181, 182–183, 233, 234, 235, 237, 238

future demand, 296

of Medicare beneficiaries, 296

participation, 233–238, 234f

sigmoidoscopy, 178–179, 180, 181, 182–183, 233, 234, 235, 296

techniques, 175

selenium intake and, 80

smoking-related, 44, 49–50

whole-grain food consumption and, 75

Community Health Centers, 7, 342–344, 423, 424

Community-level interventions, 2, 87–88

clinical training for, 300

to improve eating habits, 144–145, 147

local administration of, 107

monitoring effectiveness of, 11, 430

obstacles to cancer screening participation, 226–227

physical fitness promotion, 118, 120

policy effects, 107

recommendations, 5–6, 418–421

research, 373, 383–384

smoking cessation, 105–108

smoking prevention, 110

weight-loss programs, 133

Computed tomography, 276

cancer screening, 11

helical, 260, 276–291, 292–293

Computerized Needs-Oriented Quality Measurement Evaluation System, 335, 387

Continuing medical education, 9, 319–322

Cost-benefit analysis, 170

Cost-effectiveness analysis, 170–171

Cost-utility analysis, 171

Costs

cancer care, 20

as determinant of intervention outcomes, 102

insurance coverage for prevention efforts, 6–7, 421–423

lung cancer screening, 288, 290

obstacles to cancer screening participation, 225, 232

screening, 169–171, 181–182, 198–199, 213, 220, 222

smoking cessation programs, 105, 411

social costs of cancer, 20

state cancer control plans, 5

D

Dairy product consumption, 75–77

DCIS. See Ductal carcinoma in situ

Demographic patterns

alcohol use, 85

cancer burden distribution, 20–22

cancer screening participation, 239–240, 257

diet-related cancer risk, 81

tobacco use, 54–57, 405

See also Elderly patients;

Race/ethnicity;

Socioeconomic status

Dental schools, 316–317

Department of Defense, 13, 390–391

Department of Health and Human Services, 12–13, 352, 383–384, 433

evaluation of federal prevention services, 8, 10–11, 424–425, 428–430

recommendations for, 4, 8, 10–11, 414, 424–425, 428–430

research programs, 371–381

Department of Veterans Affairs, 338, 391– 392

Dexfenfluramine, 131

Diabetes, 17, 58, 66

Diagnostic testing, 156

Diet and nutrition, 86

cancer risk and, 402–403

fiber, 70, 75

fruits and vegetables, 66–72, 81

glucose metabolism, 80–81

interventions to improve eating habits, 133–134, 138–148

macronutrients, 77, 78t, 122–123

micronutrients, 77–80, 79t

milk and dairy products, 75–77

potential effectiveness of cancer prevention, 1, 30, 36, 400–401

predictive modeling of cancer reduction, 33

Suggested Citation:"Index." 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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recommendations for cancer prevention strategies, 4, 409, 414, 417

recommended daily intake, 138

red meat consumption, 72–74, 81

research, 372, 436

role of health care providers, 149–150

sociodemographic patterns, 71–72, 81

training of health care providers in, 309–312

weight guidelines, 65–66

whole-grain foods, 74–75

See also Weight-loss programs

Ductal carcinoma in situ (DCIS), 186

E

Early Lung Cancer Action Project, 277, 287, 288

Education and training of health care providers

administrators, 295

in clinical nutrition, 309–312

continuing education, 9, 319–322, 426

dental schools, 316–317

in exercise counseling, 312–313

goals, 295, 298–301

for graduate medical students, 311–313

nonphysician providers, 10, 428

nursing schools, 313–316

opportunities for improving, 330–331

for physical fitness promotion, 114

potential shortage of medical personnel, 10, 296, 297, 311, 428

private resources and programs, 328– 330

public resources and programs, 322–328

recommendations, 8–10, 425–428

in screening practices, 227–228

in smoking cessation, 307–309

types of providers in need of training, 295–298

undergraduate medical student training, 301–311

Educational attainment

cancer screening participation and, 239, 253

diet-related cancer risk and, 81

smoking risk and, 57

Effectiveness of preventive interventions

ancillary health benefits, 40

behavioral strategies, 2

characteristics of successful programs, 153–155, 407

clinical vs. public health interventions, 88–89

community-level interventions, 105, 107–108, 118, 120, 133, 144– 145

family-based interventions, 135–136

fruit and vegetable consumption, 66–72

goal-setting, 39

group interventions, 97

in health care settings, 151–152

to improve eating habits, 142–145

with minority populations, 108–109, 134–135, 147–148

pharmacological interventions, 98–99

physical fitness programs, 58, 59–61, 113, 114–115, 117, 118, 119– 120

physician involvement and, 96–97

potential, 1, 15, 28, 30, 400–401, 403

predictive models, 30–40

priority setting in clinical practice, 255– 257

program cost as factor in, 102

program impact, 88–89

prostate cancer, 208–211

recommendations for evaluation of, 9– 11, 427–430

recommendations for improving, 3–13, 410–432

research needs for improving, 13, 434

residential treatment programs, 97–98

school-based programs, 117, 119–120, 143–144

screening, 37, 161–167, 174–175, 403, 406–407

breast cancer, 188–196

improving participation, 236–238, 244–250, 254–255, 258

lung cancer, 261–264, 265–274, 277–282, 283–286, 292

measuring, 270

self-help interventions, 96

smoking cessation, 44–46, 47, 48, 49, 50, 51, 52–53, 93–101, 105, 107

smoking prevention campaigns, 109–111

systems of care as factor in, 9, 426–427

telephone counseling programs, 97, 114– 115

weight-loss programs, 124–129, 131, 132, 133, 134–138

Suggested Citation:"Index." 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.
×

whole-grain food consumption, 74–75

worksite programs, 100–101, 132, 142– 143

Elderly patients

cancer screening participation, 232, 240, 241, 242

See also Aging of population

Endometrial cancer, 53

fruit and vegetable consumption and, 71

obesity and, 62, 402

screening, 161–162

Environmental risk factors, 31–32

social cognitive theory, 91

tobacco smoke exposure, 53–54, 413f

Esophageal cancer, 44, 46, 47

alcohol consumption and, 83–84

fruit and vegetable consumption and, 67

obesity and, 64, 402

Estrogen metabolism, 53, 60, 62, 84

Ethics issues in screening, 167–169

Evaluation of prevention services, 8, 9–11, 427–430

Exercise and physical activity, 86

behavior change interventions, 111, 113–120

breast cancer and, 60, 402

cancer risk reduction, 58–61, 58t, 402

colon cancer and, 59–60

community-level programs, 118

current patterns of, 405

health benefits, 58

health care provider role in promoting, 114, 150

lung cancer and, 60

obstacles to, 405–406

policy interventions to promote, 119

potential effectiveness in cancer prevention, 1, 30, 400–401

predictive modeling of cancer reduction, 33

programs in health care settings, 113– 115

programs to reach minority populations, 119–120

prostate cancer and, 60–61

recommendations for cancer prevention strategies , 4, 409, 414–415f, 416– 417

recommended daily levels, 111

research, 372, 381, 435–436

school-based programs, 116–117

terminology and measurement, 111–112

training of health care providers in, 312–313

transportation infrastructure and, 6, 119, 381, 416

weight-loss programs, 124–127, 136–137

worksite programs for promoting, 115, 116t

F

Family-level interventions

smoking prevention, 110

weight loss, 135–136

Family planning, 7, 424

Fat, dietary, 72, 73, 76, 77

interventions to improve eating habits, 138–144, 145, 147

weight-loss programs, 122–124

Fecal occult blood testing, 176–177, 177t, 181, 182–183, 233, 234, 235, 237, 238

Federal government

cancer prevention activities, 8, 332, 364, 425

clinical guideline development, 332–335

data collection activities, 336–338

direct delivery of services, 342–352

employee health benefits, 423

evaluation of prevention services, 8, 10– 11, 424–425, 428–430

indirect service delivery, 352–364

information dissemination activities, 335–336

research activities, 368, 398–399

role in improving access of underserved populations to medical services, 7, 423–424

smoking cessation strategies, 3–4, 410– 412

support for community-based programs, 5

See also specific agency;

specific program

Fenfluramine, 131

Fiber, dietary, 70, 75, 77

Fluorescent bronchoscopy, 285–286

Folate, 78–79, 85

FRAMES, 92

Fruit and vegetable consumption, 81

bladder cancer and, 68–69

breast cancer and, 69

cancer risk and, 66–67, 67t

cervical cancer and, 71–72

Suggested Citation:"Index." 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.
×

colon cancer and, 69–70

cruciferous vegetables, 70

endometrial cancer and, 71

health benefits, 66

interventions to improve eating habits, 138–148

kidney cancer and, 72

liver cancer and, 72

lung cancer and, 69

oropharyngeal/esophageal/laryngeal cancer and, 67

ovarian cancer and, 70

pancreatic cancer and, 68

stomach cancer and, 67–68

thyroid cancer and, 71

G

Gastroesophageal reflux, 64

General Motors, 383, 423

Genetic susceptibility

breast cancer, 25–26

screening, 168–169, 195, 197–198

Gimme 5 program, 143

Glucose metabolism, 80–81

Go Girls! Program, 120

Group Health Cooperative, 102, 154f

Group interventions, 97

H

Health belief model, 89–90

Health Care Financing Administration. See Centers for Medicare and Medicaid Services

Health care providers

access of underserved populations, 7, 423–424

assessment systems, 150–151

in behavior risk reduction, 148–152

in delivery of screening services, 227– 230, 242, 409

in diet and nutrition management, 149– 150

in promoting physical fitness, 113, 114, 150

research on clinical practice, 374

in smoking cessation interventions, 94, 96–97, 149, 155

See also Education and training of health care providers

Health maintenance organizations, 152– 153, 154f, 225, 243

quality of care, 379

Health Professional Follow-Up Study, 43f, 49

Health promotion, 28–29

Health Resources and Services Administration, 305

cancer prevention programs, 342–344

clinician training programs, 10, 326– 328, 428

Health risk appraisals, 151

Health-seeking behaviors, 89–90

cost of care and, 102

dental care, 316

medical attitudes and beliefs, 230–231, 241

See also Participation in cancer screening

Healthy People 2010, 12–13, 97, 113, 149, 253, 298f, 332–333, 364, 413f, 430, 433

Helicobacter pylori, 50

Hormonal system, obesity and, 62

Human papilloma virus, 51

screening, 218–219

Hypertension, 66

I

Immigrant populations, 243

Incentives for change, 132

Incidence of cancer, 19–20, 21t, 31

bladder cancer, 47–48

breast cancer, 25

cervical cancer, 27, 51

colorectal cancer, 26–27

endometrial cancer, 52–53

kidney cancer, 48

leukemia, 52

lung cancer, 25, 45

oropharyngeal cancer, 46

potential effectiveness of preventive intervention, 1, 30, 403

predictive modeling of prevention intervention outcomes, 31–40

prostate cancer, 26, 53

stomach cancer, 50

Indian Health Service, 349–351

Insulin, 63, 80–81

Insulin-like growth factor, 63

Insurance

cancer burden distribution and, 12, 433

Suggested Citation:"Index." 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.
×

coverage for prevention efforts, 6–7, 421–423

smoking cessation interventions, 101–102

trends, 225–226

obstacles to cancer screening participation, 225, 231–232, 237, 243–244

population coverage, 225

underserved populations, 7–8, 12, 423– 424

International Agency for Research on Cancer, 4, 32, 58, 62, 414

Internet programs

cancer information programs, 335–336, 341

continuing medical education, 319–320

weight-loss programs, 130

Internet sales of controlled products, 3

Intravenous drug use, 17

J

Joint Commission on the Accreditation of Healthcare Organizations, 10, 427

Jump Into Action Program, 117

K

Kidney cancer, 44, 48

dairy product consumption and, 76

fruit and vegetable consumption and, 72

obesity and, 63, 402

red meat consumption and, 74

L

Lactose, 76–77

Laryngeal cancer, 44, 46, 47

alcohol consumption and, 83–84

fruit and vegetable consumption and, 67

Legislative action

cancer screening standards, 226

latency of effects, 39

smoking cessation strategies, 3–4

tobacco control efforts, 103–104f, 107– 108, 110–111, 411–412

Leukemia, 52–53

Lifestyle factors

evidence for cancer association, 41–42, 42f, 43f

health behavior trends, 2

maintenance of weight loss, 126

potential effectiveness of cancer prevention, 1, 403

significance of, 31–32, 41, 85–86

See also Behavioral interventions

Lifetime probability of cancer onset, 19–20

cervical cancer, 27

lung cancer, 25

prostate cancer, 26

Live for Life program, 115

Liver cancer

alcohol consumption and, 84

fruit and vegetable consumption and, 72

smoking-related, 44, 54

Lose Weight and Win Program, 119

Lung cancer, 44

alcohol consumption and, 85

carotenoid consumption and, 79–80

causes, 25

from environmental tobacco smoke exposure, 53–54

epidemiology, 25

fruit and vegetable consumption and, 69

incidence, 19, 289

lifetime probability, 25

mortality and morbidity, 25, 259

overdiagnosis, 274, 283

physical activity and, 60

potential effectiveness of preventive intervention, 1

prognosis, 25, 259

screening, 11, 158

bronchoscopy, 285–286

costs, 288, 290

effectiveness, 259, 292, 429

false-negatives, 273

future directions, 286–291, 296

guidelines, 274–276

informed consent, 289

potential for harm, 282, 284–285

radiography, 259, 261–274, 275

spiral computed tomography, 260, 276–291, 292–293

sputum cytology, 264, 265–271, 275, 285–286

technical development, 291–292

smoking-related, 45–46, 54, 401–402

sociodemographic patterns, 25

Lycopene, 71

Suggested Citation:"Index." 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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M

Mammography, 187–188, 196–197, 223, 403

Medicare coverage, 355

standards of care, 226

utilization, 225–226, 238–250, 357– 358t

Mammography Quality Standards Act, 226

Managed care, 10, 101–102, 152–153, 225, 427

Medicaid enrollment, 360–361

Mass media

antismoking campaigns, 105

coverage of medical research, 11, 431

physical fitness promotion, 120

Meat consumption, 72–74, 81

Medicaid, 8, 101, 232, 343, 359–361, 364, 425

pharmacotherapy coverage, 362–363t

preventive services, 225, 226

Medicare, 8, 101, 153, 364, 425

enrollment, 354

preventive services, 225, 226, 237, 296– 297, 355–358

quality of care, 354, 389

smoking cessation program coverage, 358–359

spending, 354

MESH headings, 368–369

Methionine, 85

Migrant Health Centers, 7, 342–344, 423, 424

Migrant populations, 31

Minnesota Heart Health Program, 118, 133, 145

Mortality and morbidity

alcohol consumption effects, 81–82

bladder cancer, 47

breast cancer, 25

screening effectiveness, 187, 189– 194, 403

cervical cancer, 27, 51, 403

colorectal cancer, 27, 233, 403

distribution by cancer type, 19, 19f, 20f, 21t, 29

distribution by cause, 18t

distribution by sex, 18t

effects of screening, 161–167, 256–257, 261–264, 265–272, 403

esophageal cancer, 46

kidney cancer, 48

laryngeal cancer, 46

lung cancer, 25, 259, 261–264, 265– 272, 401

need for screening, 157–158

obesity and, 61, 66

oropharyngeal cancer, 46–47

pancreatic cancer, 49

physical activity related to, 58

potential effectiveness of preventive intervention, 1, 400–401, 403

predictive modeling of prevention intervention outcomes, 31–40

prostate cancer, 26, 53, 207

screening effectiveness, 208–209, 213–214

treatment outcomes, 209–211

smoking cessation effects, 44–46, 47, 48, 401–402, 404

smoking-related, 28, 42

sociodemographic distribution, 12–13, 20–22, 23t, 24t, 433

stomach cancer, 50

trends, 18–20, 19f, 20f

Motivational interviewing, 92

N

National Cancer Institute, 13, 46, 286–287, 334, 364

breast cancer screening guidelines, 200, 203

budget, 371, 398

Cancer Education Survey, 306

cancer reduction goals, 33, 34–35t

clinician education programs, 322–324

Community Intervention Trial for Smoking Cessation, 105

data collection activities, 336–337, 379– 380

Division of Cancer Control and Population Sciences, 375, 376f

health disparities research, 13, 433–434

information dissemination activities, 335–336, 430, 432

predictive modeling of cancer reduction, 33, 38–39

Prostate, Lung, Colorectal, and Ovarian trial, 178

research activities, 371–380, 398

state programs, 340

National Cancer Policy Board, 15–16

National Committee for Quality Assurance, 10, 153, 427

Suggested Citation:"Index." 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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National Council of State Boards of Nursing, 314

National Dialogue on Cancer, 421

National Family Planning Program, 352

National Governors Association, 341

National Health and Nutrition Examination Survey, 64–65

National Health Interview Survey, 57, 336– 337

National Heart, Lung, and Blood Institute, 121, 123, 124–125

National Human Genome Research Institute, 380–381

National Institute of Nursing Research, 380

National Institute on Aging, 380

National Institute on Drug Abuse, 380

National Institutes of Health, 13, 174, 433

breast cancer screening guidelines, 200– 201

prostate cancer screening guidelines, 215–216

research activities, 371–381

National Library of Medicine, 368

National Lung Screening Study, 286

National Polyp Study, 175

National Technical Assistance Office, 330

National Weight Control Registry, 125

New York Academy of Medicine, 310

Next Step Trial, 142–143

Nicotine replacement therapy, 98–100

North Karelia project, 145

Nortriptyline, 98

Number-needed-to-screen, 167

Number-needed-to-treat, 167

Nurses, 296

cancer prevention activities, 313–314

smoking cessation training, 315–316

training, 313, 314–316, 328–329

Nurses’ Health Study, 43f, 49, 78–79

O

Obesity, 30, 86

associated cancer risk, 61–62, 61t, 402

breast cancer and, 62, 402

colon cancer and, 63, 402

endometrial cancer and, 62, 402

esophageal cancer and, 64, 402

health risks, 61

kidney cancer and, 63, 402

pharmacological treatments, 130–131

prostate cancer and, 62

recommendations for cancer prevention strategies, 4, 414–415f, 416–417

research, 372, 436

trends, 37, 64–65, 64f, 405

weight guidelines, 65–66

See also Weight-loss programs

Occupational disease, 31–32, 57

Office of Disease Prevention and Health Promotion, 4

Office of Family Planning, 352

Office of Management and Budget, 361– 364

Oral cancer, 44, 46–47, 54

alcohol consumption and, 83–84

dentist role in prevention, 316–317

fruit and vegetable consumption and, 67

smokeless tobacco use and, 54

Orlistat, 131

Oslo Youth Study, 117

Osteoporosis, 17

Outcomes measurement, 165–167, 379– 380, 391–392

Ovarian cancer

dairy product consumption and, 76–77

fruit and vegetable consumption and, 70

screening, 171, 174

P

Pacific Business Group on Health, 422

Pancreatic cancer, 44, 49, 54

fruit and vegetable consumption and, 68

red meat consumption and, 74

Pap smears, 218, 219, 226, 253, 350–351, 353t

Participation in cancer screening, 224

breast cancer, 225–226, 238–250

clinician factors, 227–230

colorectal cancer testing, 233–238, 234f

community factors, 226–227

health care system characteristics and, 225–227, 410

insurance coverage and, 225–226, 231– 232

patient factors, 230–233

prostate cancer, 251–252

strategies for improving, 229–230, 252, 254–255, 258, 409–410

breast cancer, 244–250

colorectal cancer, 236–238

Partnering with Employers for Prevention, 383

Suggested Citation:"Index." 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.
×

Partnership for Prevention, 256, 423

Patient role in medical decision-making, 12, 172–173, 299, 431

colorectal screening, 182–183

participation in cancer screening, 230– 233

prostate cancer screening, 215

Pawtucket Heart Health Program, 118, 133

Pharmacological interventions

Medicaid coverage, 362–363t

obesity, 130–131

for smoking cessation, 6, 98–99, 421

Pharyngeal cancer, 44, 46–47, 54

alcohol consumption and, 83–84

fruit and vegetable consumption and, 67

Physical activity. See Exercise and physical activity

Physician-Based Assessment and Counseling, 114

Physicians. See Health care providers

Planet Health, 137–138

Population attributable risk, 36

Predictive modeling of cancer reduction, 31–40

Prevention Curriculum Assistance Program, 303

Preventive Services Task Force. See Agency for Healthcare Research and Quality, Preventive Services Task Force

Primary prevention, 27–28, 29

Project LEAN, 145

PROJECT WALK, 120

Prostaglandins, 59–60

Prostate biopsy, 211–212

Prostate cancer

dairy product consumption and, 76

epidemiology, 26

lifetime probability of, 26

mortality, 26

obesity, 62

overdiagnosis, 207

potential effectiveness of preventive intervention, 36

red meat consumption and, 73–74

screening, 37, 158, 173

antigen testing, 11, 205–208, 211, 213, 214, 251, 252

cost-effectiveness, 213, 214

decision to implement, 213–217

digital rectal exam, 205, 213

effectiveness of early detection, 208– 211, 429

insurance coverage, 226

potential harms of, 211–213

practice guidelines, 215–217, 216– 217f, 223, 252

schedule, 206

utilization, 251–252

selenium intake and, 80

smoking-related, 44, 53

surgical complications, 212–213

treatment outcomes, 209–211, 214

vitamin E and, 80

Prostate, Lung, Colorectal, and Ovarian study, 286

Protein, dietary, 77

Public awareness and understanding

antismoking campaigns, 105, 110–111

breast cancer screening, 240–241, 242– 243

cancer risk, 288, 289

cancer screening participation and, 230, 245, 246

colorectal cancer, 235, 236

delivery of behavioral interventions, 88

federal government initiatives, 335–336

lung cancer screening, 287–288

of medical research, 12, 431–432

NCI research activities, 376–378

physical fitness programs, 118

prostate cancer, 251, 252

recommendations for educational interventions, 11–12, 430–432

Public Health Service Act. See Title X (Public Health Service Act)

PubMed database, 368–369

Q

Quality assurance, 151

in cancer screening, 226

in delivery of preventive services, 9–10, 427–428

Medicare mechanisms, 354

research activities, 379, 389

R

Race/ethnicity

alcohol consumption patterns, 85

breast cancer risk, 26

cancer burden distribution, 12–13, 22, 23t, 24t, 349–350

Suggested Citation:"Index." 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.
×

cancer prevention research, 374–375, 382

cancer screening participation, 239–240, 241, 243, 246, 253, 254, 257, 350

cervical cancer risk, 51

colorectal cancer risk, 26–27

colorectal cancer screening, 234

diet-related cancer risk, 81

dietary patterns, 81

health attitudes and beliefs, 230–231, 241

kidney cancer risk, 48

leukemia risk, 52

lung cancer risk, 25

obesity patterns, 65, 405

oropharyngeal cancer risk, 46

pancreatic cancer risk, 49

physical fitness interventions, 117, 118

programs to improve eating habits, 146, 147

prostate cancer risk, 26

smoking cessation, 57, 108–109

stomach cancer risk, 50

tobacco use patterns, 55–56, 405

weight-loss interventions, 134–135

Rehabilitation, 28

Research, 13

cancer control, 366, 382–383

cancer screening, 372–373, 382, 389, 436–437

community-based interventions, 373, 383–384

current state, 365

determinants of effectiveness, 13, 434

diet and nutrition, 372, 436

on effectiveness of screening, 164–167

health services, 366

informational resources, 370–371

interdisciplinary, 366–367

model programs, 396–398

needs, 367t, 434–437

obesity, 372, 436

organizational sponsors, 13, 367–368

See also specific organization

outcomes measures, 165–167

physical activity, 372, 381, 435–436

private sponsors of, 392–398, 395t

provider practices, 374

on public awareness and understanding, 376–378

public understanding of, 12, 431–432

publishing trends, 368–369

quality of care, 379

recommendations for, 13, 434

special populations, 378–379, 382, 388

spending, 398–399

tobacco, 371–372, 435

translational, 365, 366–367, 396–398

Residential treatment

smoking cessation programs, 97–98

Rice, 74–75

Robert Wood Johnson Foundation, 393–394

S

School-based programs

to improve eating habits, 143–144, 417

physical fitness, 116–117, 119–120, 416–417

for weight loss, 137–138

Screening, 17

absolute benefit, 157–158, 166–167

accuracy, 158

breast cancer. See Breast cancer, screening

Centers for Disease Control and Prevention programs, 7–8, 351– 352, 424

cervical cancer, 6, 7, 158, 171, 218–220, 221f, 223, 253–255, 403, 421

clinician compliance with guidelines, 229

colorectal cancer. See Colorectal cancer, screening

costs, 169–171, 181–182, 198–199, 220, 222

decision to implement, 171–174, 182– 183

effectiveness of early detection, 161–167, 208–211, 222, 259

evaluation of effectiveness, 11, 429

false-positive/false-negative results, 168– 169

genetic risk, 168–169, 195, 197–198

human papilloma virus, 218–219

insurance coverage, 6, 421, 422–423

lung cancer. See Lung cancer, screening

medical decision-making, 12

Medicare coverage, 355–358, 356t

ovarian cancer, 171, 174

overdiagnosis, 158, 207, 274

overuse, 257–258

participation in. See Participation in cancer screening

Suggested Citation:"Index." 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.
×

patient records, 229

potential effectiveness, 1, 37, 257, 401, 406

potential for harm, 167–169, 180–181, 211–213, 219, 222

practice guidelines, 174–175, 183–185, 203–204f, 216–217f, 221t, 222– 223, 346t

predictive value, 159–161, 160t

prevalence of disease and need for, 157– 158

principles of effectiveness, 157, 409

priority setting in clinical practice, 255– 257

prostate cancer. See Prostate cancer, screening

public health challenges, 224

public understanding, 11–12, 431

rationale, 28, 156

regulatory standards, 226

reliability, 158, 161

research, 372–373, 382, 389, 436–437

sensitivity, 159, 160

skin cancer, 174

specificity, 159

terminology, 156–157

test performance evaluation, 159f

utilization, 225–226, 353t, 406–407

Seattle 5 a Day Worksite Program, 143

Secondary prevention, 28, 29

Selenium, 80

Self-efficacy beliefs, 90

Self-help programs, for smoking cessation, 96

Settings for interventions

behavioral interventions, 87–89

church-based programs, 119, 147, 247f

health care settings, 113–115, 140–141, 148–153

implications for provider education and training, 295–296, 300

nurse employment patterns, 314

screening tests, 247

See also Community-level interventions;

School-based programs;

Worksite intervention

Sexual behavior, 17, 51

Sexually transmitted disease, 27

Sibutramine, 131

Sigmoidoscopy, 178–179, 180, 181, 182– 183, 233, 234, 235, 237, 296

Skills-training, 92, 93f

weight-loss programs, 127

Skin cancer, 80

screening, 174

Smoking cessation, 2, 275–276

cancer risk reduction, 45–46, 47, 48, 49, 50, 51, 52–53, 401–402

characteristics of successful programs, 93–96, 154f

community-level interventions, 105–108

cost-effectiveness of, 105

dentist role in, 316–317

education and training of health care providers for, 307–309

effectiveness of behavioral interventions, 94, 95t, 96–101

federal programs, 8, 425

future demand for services, 297

group interventions, 97

health benefits, 44–45

health care providers involved in, 297

insurance coverage for, 6, 101–102, 421, 423

lay treatment counselors, 317–319

legislative action to encourage, 3–4, 410–412

Medicaid programs, 361

Medicare coverage, 358–359

NCI research, 371–372

nurse training for, 315–316

obstacles to service delivery, 155

pharmacological interventions, 98–99

potential public health benefits, 28

private research initiatives, 393–395, 396

program costs, 102, 411

programs for underserved populations, 108–109

research needs, 435

residential treatment programs, 97–98

role of health care providers, 8, 94, 96– 97, 149, 425

self-help programs, 96

sociodemographic patterns, 57

stepped treatment, 297–298

telephone counseling programs, 97

trends, 404–405

weight gain and, 45

worksite interventions, 100–101

See also Smoking-related cancer;

Tobacco use

Smoking-related cancer

alcohol consumption and, 47, 83

bladder cancer, 47–48

Suggested Citation:"Index." 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.
×

colon cancer, 49–50

environmental tobacco smoke, 53–54, 413f

kidney cancer, 48

latency of intervention strategies, 39

leukemia, 52–53

lung cancer, 45–46, 401

mortality, 28, 42, 401, 404

oropharyngeal cancer, 46–47

pancreatic cancer, 49

potential effectiveness of preventive

intervention, 1, 30, 36, 400–401

prostate cancer, 53

stomach cancer, 50

trends, 25, 42, 86, 291

types of diseases, 44, 44t

See also Lung cancer;

Smoking cessation;

Tobacco use

Social cognitive theory, 91

Society of Thoracic Radiology, 288

Socioeconomic status

cancer burden distribution, 12, 22

cancer screening participation and, 226– 227, 230, 232, 239, 242, 243, 257

diet-related cancer risk and, 71–72, 81

interventions to improve eating habits, 147–148

lung cancer risk, 25

tobacco use, 55–57

Spiral computed tomography, 260, 276– 291, 292–293

Sputum cytology, 264, 265–271, 275, 285– 286

Stanford Five-City Study, 118, 133

Stanford Three-City Community Study, 145

Starch, dietary, 77

State government

cancer control plans, 5, 418–421

cancer prevention activities, 338–341

community-based programs, 5–6

mandated insurance coverage, 421

Medicaid programs, 359–361

monitoring of preventive services, 9

nurse licensure, 314

physical education requirements, 417

smoking cessation programs, 3–4, 101, 102, 317–319, 411

tobacco control efforts, 103–104f, 107– 108, 110–111, 407–408, 410– 412

Stomach cancer, 44, 50

fruit and vegetable consumption and, 67–68

whole-grain food consumption and, 75

Substance abuse as cancer risk factor, 17.

See also Alcohol consumption

Substance Abuse Prevention and Treatment Block Grant awards, 3

Sun exposure, 17

Surveillance, 156–157

government programs, 336–338

Surveillance, Epidemiology, and End Results Program, 32

Swedish Two-County Trial, 189, 194

Synar amendment, 3

Systems of health care

behavior risk reduction in, 148–153

cancer screening, 225–227, 409

delivery of behavioral interventions, 87, 88–89

determinants of screening participation, 225–227

effective delivery of prevention services, 9, 426–427

public health infrastructure, 418

public health mission, 419f

T

Taxation, 3, 39, 111, 410, 412

Telephone counseling

to improve eating habits, 145

in promoting physical fitness, 114–115

screening reminders, 245–246, 248–249

for smoking cessation, 97

weight-loss programs, 129–130

Tertiary prevention, 28

Testicular cancer screening, 161–162

Theory of Planned Behavior, 90

Theory of Reasoned Action, 90–91

Thyroid cancer, 71

Title X (Public Health Service Act), 7, 352, 423, 424

Tobacco use

characteristics of effective interventions, 407–408, 408f

geographic variation, 358

legislative efforts to control, 103–104f, 107–108, 110–111

NCI research, 371–372, 375–376

Suggested Citation:"Index." 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.
×

objectives of programs to reduce, 413f

pipes and cigars, 54

prevention of, 109–111

private research initiatives, 393–395, 396

recommendations for regulation of, 3–4, 410–412

research needs, 435

smokeless tobacco, 54

sociodemographic patterns, 54–57, 405

trends, 403–405

vendor licensing, 3

Tomatoes, 71

Transdisciplinary Tobacco Use Research Centers, 396

Translational Research Centers in Behavioral Science, 398

Transportation Equity Act for the 21st Century, 6

Transportation infrastructure, 6, 119, 381, 416

Transtheoretical model of change, 91–92

Treatwell study, 142

Trevose program, 129

U

Underserved populations

cancer burden, 12–13, 22, 433

cancer prevention research, 374–375

cancer screening, 257

clinician skills for service delivery to, 299

health disparities research, 378–379, 382, 388

physical fitness programs, 119–120

programs to improve eating habits, 146– 148

recommendations for improving access to services, 7–8, 423–424

smoking cessation programs, 108–109

weight-loss programs to reach, 134–135

University of Alabama, 310

University of Arizona, 310

University of California, 310

University of Colorado, 310

University of Nevada, 310

University of North Carolina, 310

University of Texas, 311

V

Value expectancy theory, 89–91

Vegetables. See Fruit and vegetable consumption

Veterans Health Administration, 344–349

Vitamin A, 79

Vitamin C, 50

Vitamin D, 76

Vitamin E, 80

W

Weight-loss programs, 409

behavioral programs, 127–129

commercial, 129

community-based, 133

dietary restriction, 120–125, 136

environmental approaches, 133–134

goals, 120

maintenance of weight loss, 125–127

mediated approaches, 129–130

pharmacological treatments, 130–131

physical activity interventions, 124–127, 136–137

to reach underserved populations, 134– 135

worksite, 131–132

for young people, 135–138

Weight Watchers program, 129

Wheat, whole-grain, 74–75

Whole-grain foods, 74–75

Women’s health

cancer risk, 22, 25

oropharyngeal cancer risk, 46

screening programs, 7

underserved populations, 7

Working Well, 142

Worksite intervention

CDC programs, 383–384

fitness programs, 4

to improve eating habits, 133–134, 142– 143

insurance coverage for prevention efforts, 6–7, 422–423

promoting physical fitness, 115, 116t

screening, 247f

smoking cessation programs, 100–101

state support for, 5

weight-loss programs, 131–132

Suggested Citation:"Index." 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.
×

Y

Young people

access to tobacco, 3, 4

physical fitness, 4, 116–117, 119–120, 136–137, 405–406, 414, 416– 417

programs to improve eating habits, 4, 143–144, 414, 417

smoking prevention campaigns, 109–111

tobacco use patterns, 54–55, 56t, 404– 405

weight-loss interventions, 135–138

Suggested Citation:"Index." 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 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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