Cancer prevention and detection. Status report and future prospects

Today 50% of all people with newly diagnosed cancer will survive 5 years, compared with only 20% in the 1930s. This success has been accomplished by advances in early diagnosis and therapy. In 1980, the American Cancer Society (ACS) reasserted its emphasis on early detection with the publication of guidelines for the cancer-related check-up which include recommendations for the early detection of cancer of the cervix, breast, and large bowel. These recommendations as well as detection of early lung cancer are discussed. Prevention of death by early detection and effective therapy is a precursor to efforts to prevent clinical cancer entirely. Thirty-three percent of cancer deaths could be avoided if people chose not to use tobacco. Diet and nutrition probably account for another 33% of cancers. In 1984 the ACS published dietary recommendations for cancer risk reduction; these are discussed in the text. The status of prevention and detection is reviewed and some speculation is made about future prospects.