مجله اپیدمیولوژی ایران (Dec 2005)
Cancers and Prevention strategies
Abstract
Epidemiological studies of cancer is the corner stone of cancer control plans and necessary for setting goals, monitoring the progress, and evaluating the results of control efforts. Cancer is a generic name for a number of diseases that have different etiology, natural history, and outcome. Thus, control activities for each cancer is different and requires varied approaches. Primary prevention, i.e., controlling the initiation of cancers is now possible for a number of cancers including lung, stomach, liver, and cervix by controlling the use of tobacco, and infections with Helicobacter pylori, Hepatitis C, and Human papilloma viruses. Secondary prevention, i.e., early detection is mostly effective for the cancers of the breast (mammography), cervix (Pap test), prostate (digital rectal exam and PSA testing), colon and rectum (Colon- and Sigmoidscopy), and melanoma of the skin (clinical examination of the skin). Effective treatment is now possible for a large number of cancers with arrays of new medications such as Tamoxifen and Herceptin for breast cancer, Avastin for Colorectal and other cancers, and so on. Tertiary prevention, i.e., rehabilitation and hospice care is a necessary part of cancer control that is generally neglected. Cancer is a familial disease and when it struck, it affects the whole family. Health education and social support for the patients and their families is an integral part of cancer control activities and must be present in any effective cancer control program. Tertiary prevention not only includes proper palliative care, but also education and support for proper nutrition and improvement of the quality of life for the patient and the family.