Fulfilling the Potential of Cancer Prevention and Early Detection (2003) / Chapter Skim
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Executive Summary
Executive Summary
Pages 1-14
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To save the most lives from cancer, health care providers, health plans, insurers, employers, policy makers, and researchers should be concentrating their resources on helping people to stop smoking, maintain a healthy weight and diet, exercise regularly, keep alcohol consumption at low to moderate levels, and get screened for breast, cervical, and colorectal cancer. The health benefits of such behavioral changes extend beyond cancer to cardiovascular disease and diabetes as well.
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The report examines · the extent to which the burden of cancer could be reduced through cancer prevention and early detection; · the effectiveness of cancer screening methods and interventions to alter smoking, eating, and exercise habits;) tons; · approaches to enhancing the potential benefits of proven interven· a case study of screening for lung cancer, illustrating the problem of adopting new technology when the science is uncertain; · professional education and training needs; · federal and state programs that support cancer prevention and early detection; and iThe Board recognized that a number of personal and health care behaviors are known to contribute to the burden of cancer but limited its review to tobacco use, obesity, physical activity, diet, alcohol use, and the use of screening tests.
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States should set sufficiently high levels of excise taxation on tobacco products to discourage tobacco use, but levels should not be so high that they encourage significant tax avoidance activities. · States should allocate sufficient funds from the Tobacco Master Settlement Agreement and tobacco excise taxes to support comprehensive, state-based tobacco control efforts consistent with guidelines of the Centers for Disease Control and Prevention.
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Among youth, school policies regarding healthy school lunches, physical education requirements, and the availability of after-school recreational programs improve nutrition and affect rates of participation in exercise. The National Cancer Policy Board endorses the comprehensive Recommendations for Public Health Action on Weight Control and Physical Activity to Promote Cancer Prevention proposed by the International Agency for Research on Cancer, an agency within the World Health Organization (International Agency for Research on Cancer, 2000)
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Health departments can, for example: · monitor and publicize state trends in cancer and cancer-related behaviors; · support media campaigns to promote healthy behaviors; · target interventions to low income and racial/ethnic groups at high risk for cancer, e.g., by providing breast, cervical, and colorectal cancer screening services to medically uninsured and medically underserved populations; · develop and distribute best-practice guidelines to major employer human resources departments to encourage smoking cessation programs, weliness programs, on-site healthy eating and exercise facilities, flexible time for employees to allow alternative means of commuting (e.g., by bicycle or foot) , and use of preventive health services (e.g., screening and smoking cessation programs)
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, which provides federal funds to construct sidewalks and bicycle trails and to integrate mass transit, roads, and pedestrian and bicycle facilities into a comprehensive transportation plan; · support free and reduced-fee health clinics organized through local health departments and other community-based programs; and · evaluate the effectiveness of services and programs. Recommendation 4: Public and private insurers and providers should consider evidence-based cancer prevention and early detection services to be essential benefits and should provide coverage for them.
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rely on a patchwork of public and private programs for primary care (IOM, 20003~. Community and Migrant Health Centers and Title X family planning clinics are vital sources of primary health care and are important providers of cancer prevention and early detection services.
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The federal government administers or funds Medicare; Medicaid; the Health Resources and Services Administration's Community and Migrant Health Centers; Title X family planning clinics; the U.S. Department of Agriculture's programs such as the Special Supplemental Nutrition Program for Women, Infants, and Children; the Indian Health Service; U.S.
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· State health departments could use data from cancer registries to examine regions and population subgroups characterized by high rates of late-stage diagnoses of breast, cervical, and colorectal cancer, for which screening programs are available, to identify where to target outreach efforts.
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The U.S. Preventive Services Task Force, overseen by the Agency for Healthcare Research and Quality, has provided comprehensive assessments of clinical prevention services.
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As state efforts to implement comprehensive cancer control plans gain momentum, guidance on the effectiveness of public health interventions will be critically needed. The Board recommends that support for both task forces be sufficient for systematic syntheses and meta-analyses of data from the literature and to keep abreast of developments in both clinical and community disease prevention and health promotion.
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Department of Health and Human Services and Office of Disease Prevention and Health Promotion, 2000~. Lack of health insurance coverage is a key predictor of lower rates of use of cancer screening tests.
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Department of Defense, and the American Cancer Society should expand their support of applied behavioral research and how best to disseminate evidence-based prevention interventions. Effective strategies are especially needed to encourage healthy behaviors among children and their families, medically underserved populations, and the public at large through multicomponent interventions.
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