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PubMed1984

Knowledge of testicular cancer risk and need for self-examination in college students: a call for equal time for men in teaching of early cancer detection techniques.

College athletes were surveyed about their knowledge and practice of early cancer detection techniques. Males were almost completely unaware of their risk for testicular cancer (87%). Only 9.6% had been taught testicular self-examination and only half of these by their physician. Six percent actually examined themselves regularly. In comparison, more than 60% of women had been taught breast self-examination (75% by a physician) and about one third were doing regular examinations. More than 90% of the young men and women had been seen by physicians for a physical examination within the past 3 years. Physicians need to begin educating males about testicular cancer and its early detection.

Adolescent↗

PubMed1999

CaDet, a computer-based clinical decision support system for early cancer detection.

Cancer risk evaluation and early detection are subject to serious limitations mainly related to human factors and to characteristics of the data involved. To help overcome these problems, a computer-based system was designed to provide the physician with a clearer clinical picture and aid in directing patients to appropriate measures. Clinical and epidemiological data related to early cancer detection and to cancer risk factors was collected from the literature and incorporated in a database, together with heuristic rules for evaluating this data. Individual data obtained from patients through a questionnaire are input into CaDet, a computerized clinical decision support system. A report summarizing patient data and cancer hypotheses, with a scoring system that reflects degrees of alarm, is generated. The CaDet system, as well as some preliminary results of the clinical experience accumulated in its use, are described. These preliminary results suggest that the approach may be useful in improving cancer risk assessment and screening in primary care setups.

Adult↗

PubMedDate not supplied

The benefit and cost of prostate cancer early detection. The Investigators of the American Cancer Society-National Prostate Cancer Detection Project.

Cost-effectiveness calculations of prostate cancer early detection have not been possible due to the lack of any data demonstrating reduction in mortality from any test or procedure. Prior analyses focused only on cost assessments without consideration of any possible benefits. We used current data from three consecutive years of the American Cancer Society-National Prostate Cancer Detection Project to assess different economic perspectives of test performance, marginal costs, and benefit-cost analysis. The marginal cost, or cost per cancer, of digital rectal examination (DRE) markedly increased by the third year relative to several proposed prostate-specific antigen (PSA) scenarios. Sensitivity analysis for average cost showed that at 4 ng/ml, pricing PSA below $30 would be the most potent factor in potentially lowering costs. Analysis of receiver operator characteristic curves suggested that optimal performance for PSA may be at 3 ng/ml when combined with DRE or between 2 to 3 ng/ml when used alone. Benefit-cost calculations demonstrated that DRE when performed by highly skilled examiners had the lowest cost. However, DRE became one of the most costly detection scenarios when a minor decrease in performance was assumed. Sensitivity analysis demonstrated that the three most determinant parameters of net benefit, in decreasing order, are: specificity, benefits from earlier therapy, and prevalence. If a slightly more specific PSA assay is developed, the higher prevalence of clinically detectable prostate cancer could also make screening less costly than breast cancer screening. Under the assumptions of these analyses, the combination of PSA and DRE appears to represent an ethical and economical detection choice for individual patients in consultation with their physicians. Additional research is needed to quantify the significance of differences between different screening strategies.

American Cancer Society↗

PubMed2004

Analytical validation of telomerase activity for cancer early detection: TRAP/PCR-CE and hTERT mRNA quantification assay for high-throughput screening of tumor cells.

Activation of telomerase plays a critical role in unlimited proliferation and immortalization of cells. Telomerase activity has been shown to correlate with tumor progression, indicating that tumors expressing this enzyme possess aggressive clinical behavior and that telomerase activity may be a useful biomarker for early detection of cancer. However, measurements of telomerase activity by current methods such as telomeric repeat amplification protocol (TRAP)/polymerase chain reaction (PCR) or antibody-based radioimmunoassay (RIA) are low-throughput and not robust enough to easily accommodate the required statistical analysis to determine whether telomerase activity is a practical biomarker. As part of the National Cancer Institute Early Detection Research Network of analytical validation, we have developed a robot assisted TRAP assay (RApidTRAP) of telomerase, a potential biomarker for cancer early detection. Measurements of human telomerase reverse transcriptase catalytic subunit (hTERT) mRNA were performed in concert with measurement of telomerase activity. For this purpose we determined hTERT mRNA concentration and telomerase activity in human normal (RPE-28) and cancer (A549) cell lines as well as in human serum (SRM 1951A). Telomerase activity measurements were made using the TRAP/PCR capillary electrophoresis (CE) method on (50 to 1000) cells/reaction isolated from cell extracts. Measurement of hTERT mRNA was made using specific primers and probes on a LightCycler in the range of (10 to 7000) cells/reaction. Comparison of high-throughput telomerase activity measurements using the robot and those performed manually were consistent in sensitivity and reproducibility. Using this combination of telomerase activity and hTERT mRNA measurements, the automated system improved efficiency over traditional TRAP/PCR methods.

Biomarkers↗

PubMed2007

Impact of the National Breast and Cervical Cancer Early Detection Program on mammography and Pap test utilization among white, Hispanic, and African American women: 1996-2000.

Prevention, including routine cancer screening, is key to meeting national goals for the elimination of death and suffering due to cancer. Since 1991, the U.S. government has invested in programs such as the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) to detect breast and cervical cancer early among uninsured low-income women. A concomitant goal is reducing racial disparities in screening and early detection, and the NBCCEDP program targets low-income women who are more often racial and ethnic minorities. This paper analyzes data to test for effects of the NBCCEDP and other determinants of screening across racial/ethnic groups. We used data from the Behavioral Risk Factor Surveillance System (BRFSS) for 1996 through 2000. These data indicate that gaps in testing for breast and cervical cancers between African American and non-Hispanic white women aged 40-64 years have closed but remain for Hispanics. Multivariate findings indicate that the longevity of free screening sites through the NBCCEDP significantly increased both tests for non-Hispanic white women. The data do not confirm this effect for other racial and ethnic groups. Analysis did indicate that public insurance, or Medicaid, was equal to private insurance in promoting increased testing for African Americans and Hispanics, but not for non-Hispanic whites. Assuring that Medicaid remains available for women in this nonelderly group and increasing access to free screening sites can lead us closer to national screening goals, yet policies still need to address racial/ethnic disparities in insurance and service delivery. Cancer 2007. (c) 2006 American Cancer Society.

Adult↗

PubMed2003

A feasibility study of the evaluation of the Florida breast cancer early detection program using the statewide cancer registry.

In Florida, a Center for Disease Control and Prevention (CDC)-funded initiative of the Florida Department of Health has targeted socio-economically disadvantaged women for breast and cervical cancer screening. Since 1995, over 12,000 women aged 50-64, within 200% of the federally defined poverty level, with no health insurance, and living in metropolitan catchment areas in Florida, have been screened by the Florida Breast and Cervical Cancer Early Detection Program (BCCEDP). This was a matched cohort cross-sectional analysis of a cohort study of Florida women with breast cancer using the Florida incident cancer registry, the Florida Cancer Data System (FCDS). The study evaluated the hypothesis that there would be no difference in the stage at diagnosis between breast cancer cases in the BCCEDP-screening program and breast cancer cases not diagnosed in the screening program. After linking the BCCEDP records with the FCDS, BCCEDP-screened cases were matched on gender, age, race, ethnicity, and other variables with five groups of FCDS breast cancer cases not screened by BCCEDP to control for demographic and socio-economic factors. Breast cancer cases diagnosed in BCCEDP were significantly more likely to be diagnosed at later stage than non-BCCEDP breast cancer cases in the five matched groups. The BCCEDP is not purely a screening program since it also caters to symptomatic women in the indigent population, therefore these finding were expected. In fact, 71% of the BCCEDP cases were symptomatic at the time of screening/diagnosis and 53% were late-stage diagnosed. These findings show that BCCEDP is indeed servicing its targeted population of medically under-served and symptomatic women in Florida. Furthermore, despite limitations, this study illustrates the potential collaboration between cancer registries and breast cancer screening programs for quality control purposes.

Breast Neoplasms↗

PubMed1994

The early detection of second primary lung cancers by sputum immunostaining. LCEWDG Investigators. Lung Cancer Early Detection Group.

STUDY OBJECTIVE: To determine whether monoclonal antibody (Mab) detection of tumor-associated antigen expressed on sputum epithelial cells precedes clinical presentation of second primary lung cancer. DESIGN SETTING/PARTICIPANTS: Eleven oncology centers collaborate in the accrual of 1,000 patients with stage I non-small cell lung cancer (NSCLC) who had undergone resection. The Mabs examined in this study (624H12, 703D4) detect two promising oncofetal/differentiation markers (ie, a difucosylated Lewis X and a 31-Kd glycoprotein antigen). INTERVENTIONS: Induced sputum specimens are evaluated for quality, then are Papanicolaou and immunostained by independent central laboratories at enrollment and annually thereafter. The predictive value of Mab markers is compared with routine morphologic study for detection of second primary lung cancer during an anticipated 3 years of accrual and 1 year of follow-up. MEASUREMENTS AND RESULTS: Five hundred eighty of an anticipated 1,000 patients have been accrued on schedule. Patients are primarily white (88.6%), former smokers (75.9%), men (55.6%), with a median age of 66.7, and joined the study at an average of 3.7 years following resection of a stage 1 NSCLC (34.4% squamous, 43.6% adenocarcinoma). Central laboratories found less dysplasia and more unsatisfactory specimens (27.3%) than do the accrual institution laboratories. Immunostaining identifies more suspicious cells than does morphologic study. However, only two second primary lung cancers (eight total deaths) have occurred to date. CONCLUSIONS: Halfway through the accrual, we describe the study design and preliminary observations. This study illustrates rational selection of carcinogenesis markers by linkage of marker expression on preneoplastic specimens with subsequent expression on tumor tissue.

Aged↗

PubMedDate not supplied

[Counseling protocol for early cancer detection at the Women's Health Center in Ruma].

INTRODUCTION: Women's health care office in Ruma Health Center provides health care for women of Ruma and Irig communities. According to census in 1991, Ruma community has 55.063 inhabitants; 28.266 women out of which 13.149 are of reproductive age. Irig community, has 11.696 inhabitants, 6.072 women and 2.526 are of reproductive age. PROTOCOL: According to protocol each woman who consults her gynecologist, is thoroughly examined. The overall examination included the following: anamnesis in regard to risk factors for malignant diseases of female genital organs and breast, speculum examination, cytologic smear, colposcopy, palpatory examination of breast gynecological palpatory examination. On the basis of gathered results, further examinations, if necessary, were carried out: cervical biopsy, endocervical curettage, ultrasound examination, mammography and so on. Two groups of patients were formed on the basis of gathered results--high-risk group and "no-risk" group of patients with no risk from malignant disease. The high-risk group of patients has a separate file and is actively controlled; if necessary this group is called for check-ups at intervals from six months to a year periods. The group of "no-risk" patients is controlled once in a three-year period. FORMING THE HIGH-RISK GROUP: High-risk group in regard to a malignant disease of the cervix is formed on the basis of the following findings: 1. Positive family history (mother, aunt, sister, etc.). 2. Positive personal history (positive sexual factor, early sexual relations, early marriage, more sexual partners, more marriages, bad sexual hygiene, human papilloma virus infection (HPV), herpes simplex virus infection, bad living and social conditions, smoking, intra-uterine and oral contraception, immune suppression, and human immune deficiency virus infection (HIV). 3. Positive clinical findings: chronic cervicitis, condylomas. 4. Positive laboratory findings: positive cytological smear, all atypical colposcopic findings, all histopathological findings of precancerous, high oncogenes groups of HPV. 5. Detected cases of malignant disease of the cervix uleri. Cervical biopsy is performed in each woman with positive cytologic and colposcopic findings. Histopathological findings are done according to Bethesda system. HPV classification according to type is done with LSIL changes, and if a high oncogenes HPV type is obtained, women require conisation of the cervix uteri. With HSIL changes, women require cervix conisation. Invasive forms of cervix uteri malignant disease, require treatment in Oncology Institute. High-risk group for endometrial and breast carcinomas is formed on the basis of positive family and personal history, positive clinical and laboratory findings. High-risk women have separate files (marked with "R") and if necessary they are asked for additional check-up. RESULTS: In the framework of the Office for early cancer detection the Cancer Registry (2,3) contains the following: personal data, address, date of disease detection, diagnosis and the disease stage, way of treatment, outcome and a questionnaire on risk factors. Morbidity of precancerous and malignant diseases of female genitalia and breast as well as mortality will be monitored in the forthcoming period. CONCLUSION: We consider the Protocol of work of the Office for early detection of cancer to be an acceptable and compulsory model for protection of women by existing public health services. 1. Each woman who comes to see her gynecologist for examination, should be systematically examined; the risk of malignant disease and necessary further examinations also must be determined. 2. An accurate file on high-risk group must be kept and women should be actively called to come for check-ups, unless they do it in an appointed period--one year at the latest. 3. Women should be kept informed, through local media, about the importance of overall examinations and risk factors for malignant diseases in women. 4.

Breast Neoplasms↗

PubMed1995

Molecular markers in early cancer detection. New screening tools.

Better early detection strategies for lung cancer are clearly needed. About 20 years ago, cytomorphologic criteria were developed for use in staging bronchial epithelium carcinoma. Yet, when sputum cytology was added to chest radiograph in the largest early-screening-of-lung-cancer study carried out to date, the three-arm trial sponsored by the National Cancer Institute, no major outcome benefit was shown. Sputum samples of participants in one of these trials, the Johns Hopkins Lung Project, have been archived. Currently, sputum immunostaining using two monoclonal antibodies directed at a difucosylated Lewis X epitope and a 31-kilodalton protein show correlation between positive staining of these samples and eventual development of lung cancer in the sampled population. Strategies to neutralize the stimulation of growth factors like gastrin-releasing peptide, which are seen in small-cell disease, are also being explored. Development of an epithelial-directed diagnostic test is the most important goal in obtaining early detection tools for lung cancer. Several new tests await prospective trials to evaluate their utility. In developing an early detection test for lung cancer, due to the chronic nature of the risk and the vast at-risk population, cost and patient compliance are two major concerns.

Antibodies, Monoclonal↗

PubMed1988

A survey of physicians' breast cancer early detection practices.

Early detection of breast cancer through the use of mammography reduces long-term mortality from this disease, yet relatively little is known about its acceptance by the medical community. As part of a state health department cancer control program planning effort, we contacted 1,004 primary-care physicians in Pennsylvania to ascertain current breast cancer early detection practices. While 92% of the 557 eligible respondents reported conducting breast physical examinations at least annually in asymptomatic women age 50 or older, annual mammograms for this age group were ordered by only 42% of physicians. Obstetrician-gynecologists, as well as female and younger physicians, were more likely to obtain nondiagnostic mammograms regularly. Factors reported by physicians as affecting their practice of obtaining mammograms varied by patient age and, among patients 50 years and older, included the claim that their mammography practices represented optimal care (57% of the physicians), how often the patient visited their office (23%), patient refusal (16%), and cost of the examination (16%). Fear of radiation and expense were cited as the primary reasons for patient refusal. Public and physician education, as well as third-party payment changes, was viewed by the physicians as the most effective means to increase the level of breast cancer early detection in their geographic areas. This survey shows that the use of nondiagnostic mammography is still less than optimal, and identifies impediments to screening that need to be addressed in cancer control planning efforts.

Adult↗

PubMed2001

Screening sensitivity and sojourn time from breast cancer early detection clinical trials: mammograms and physical examinations.

PURPOSE: To estimate sensitivities of breast cancer screening modalities and preclinical duration of the disease from eight breast cancer screening clinical trials. PATIENTS AND METHODS: Screening programs invariably lead to diagnosis of disease before signs or symptoms are present. Two key quantities of screening programs are the sensitivity of the disease detection modality and the mean sojourn time (MST). The observed screening histories in a periodically screened cohort make it possible to estimate these quantities of interest. We applied recently developed statistical methods to data from eight randomized breast cancer screening trials to estimate the sensitivities of early detection modalities and MST. Moreover, when a screening trial involved two screening modalities, our methods enabled the estimation of the individual sensitivity of each screening modality. RESULTS: We analyzed breast cancer data from several screening trials and have relatively complete data from the Health Insurance Plan (HIP), Edinburgh, and two Canadian studies. The screening sensitivity for mammography, physical examination, and MST were, respectively, HIP: 0.39, 0.47, and 2.5 years; Edinburgh: 0.63, 0.40, and 4.3 years; Canadian (age 40 to 49 at entry): 0.61, 0.59, and 1.9 years; Canadian (age 50 to 59 at entry): 0.66, 0.39, and 3.1 years. CONCLUSION: The public debate on early breast cancer detection is mainly centered on mammograms. However, the current study indicates that a physical examination is of comparable importance. Cautious interpretation of trial differences is required as a result of various experimental designs and the age dependency of screening sensitivity and MST.

Adult↗

PubMed2005

Report from the CDC. Pap test intervals used by physicians serving low-income women through the National Breast and Cervical Cancer Early Detection Program.

The National Breast and Cervical Cancer Early Detection Program (NBCCEDP), administered by the Centers for Disease Control and Prevention (CDC), provides breast and cervical cancer screening to low-income women who are uninsured or underinsured. For women with three consecutive annual Pap tests with normal findings, the NBCCEDP supports extending the screening interval to every 3 years. Thirteen telephone focus groups were conducted with physician providers in 17 states and the District of Columbia to investigate familiarity with NBCCEDP's triennial Pap test policy, the Pap test intervals actually used, and the factors influencing screening interval selection. No participants were familiar with NBCCEDP's triennial Pap test policy, and none reported routinely extending the screening interval after three consecutive annual Pap tests with normal findings. Two patterns of screening interval use were reported: annual screeners continued performing yearly Pap tests, and selective extended screeners offered an extended interval to select patients. Annual and selective extended screeners reported that both unique and common factors influenced the screening intervals they used. The NBCCEDP has established its cancer screening priorities to focus limited resources on the goal of providing services to eligible women who have rarely or never been screened. Increased efforts are needed to educate physicians about the science supporting an extended Pap screening interval and overcome the barriers associated with its adoption.

Adult↗

PubMed2006

Bead-based ELISA for validation of ovarian cancer early detection markers.

PURPOSE: Efforts to validate ovarian cancer early detection biomarkers with immunoassays are challenged by the limited specimen volumes available. We sought to develop a specimen-efficient assay to measure CA125 in serum, assess its reproducibility, validity, and performance, and test its potential for multiplexing and combining with human epididymis protein 4 (HE4), a promising novel ovarian cancer marker. EXPERIMENTAL DESIGN: Four pairs of commercially available anti-CA125 antibodies and one pair of anti-HE4 antibodies were evaluated for accuracy in measuring known concentrations of antigen on a bead-based platform. The two best pairs were further assessed for reproducibility, validity, and the ability to discriminate between blinded serum samples obtained from ovarian cancer cases (n = 66) and women without ovarian cancer (n = 125). RESULTS: Suitability for use in a bead-based assay varied across CA125 antibody pairs. Two CA125 bead-based assays were highly reproducible (overall correlations between replicates >/= 0.95; coefficients of variation < 0.2) and strongly correlated with the research standard CA125II RIA (correlations >/= 0.9). Their ability to distinguish ovarian cancer cases from non-cases based on receiver operating characteristic analyses (area under the curve, AUC, of 0.85 and 0.84) was close to that of the CA125II RIA (AUC, 0.87). The HE4 bead-based assay showed lower reproducibility but yielded an AUC of 0.89 in receiver operating characteristics analysis. Multiplexing was not possible but a composite marker including CA125 and HE4 achieved an AUC of 0.91. CONCLUSION: Optimization procedures yielded two bead-based assays for CA125 that perform comparably to the standard CA125II RIA, which could be combined with an HE4 bead-based assay to improve diagnostic performance, and requires only 15 muL of sample each.

Adult↗

PubMed2004

On-schedule mammography rescreening in the National Breast and Cervical Cancer Early Detection Program.

OBJECTIVE: The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides free cancer screening to many low-income, underinsured women annually but does not routinely collect all data necessary for precise estimation of mammography rescreening rates among enrollees. MATERIALS AND METHODS: To determine the percentages rescreened and to identify factors that encourage on-schedule rescreening, telephone interview and medical record data were collected from 1685 enrollees in Maryland, New York, Ohio, and Texas at least 30 months after their 1997 index mammogram. RESULTS: Overall, 72.4% [95% confidence interval (95% CI) = 70.1-74.7] were rescreened within 18 months and 81.5% (95% CI = 79.6-83.5) within 30 months. At 30 months, the adjusted odds ratios (ORs) for rescreening were higher among Hispanics (OR = 1.95, 95% CI = 1.15-3.28), women with a history of breast cancer before the index mammogram (OR = 3.36, 95% CI = 1.07-10.53), and those who had used hormone replacement therapy before their index mammogram (OR =1.94, 95% CI = 1.30-2.91). The 30-month adjusted ORs were lower for women who reported poor health status (OR = 0.60, 95% CI = 0.42-0.85), did not have a usual source of care (OR = 0.61, 95% CI = 0.40-0.94), did not know if they could have another free mammogram (OR = 0.28, 95% CI = 0.14-0.51), described their index screen as their first mammogram ever (OR for no prior mammograms versus three or more = 0.40, 95% CI = 0.27-0.60), did not recall receiving a rescreening reminder (OR = 0.35, 95% CI = 0.25-0.48), or did not think they had been encouraged to rescreen by their provider (OR = 0.61, 95% CI = 0.44-0.86). DISCUSSION: Rescreening behavior in this sample of NBCCEDP enrollees was comparable with that observed in other populations. To facilitate routine rescreening among low-income women, ongoing efforts are needed to ensure that they receive annual reminders and encouragements from their medical providers and that they know how to obtain the services they need.

Aged↗

PubMed2005

The effects of a National Breast and Cervical Cancer Early Detection Program on social disparities in breast cancer diagnosis and treatment in Massachusetts.

OBJECTIVE: To assess social disparities in breast cancer diagnosis and treatment by comparing the stage at diagnosis and treatment of women diagnosed with breast cancer through a National Breast and Cervical Cancer Early Detection Program (NBCCEDP) for low income and uninsured women in Massachusetts, the Women's Health Network (WHN), to other breast cancer patients in the state. METHODS: We linked data from the WHN and the Massachusetts Cancer Registry (MCR). We compared 331 WHN women and 13,372 other breast cancer patients in Massachusetts diagnosed from 1995 to 1999. We used logistic regression, controlling for age, race/ethnicity, marital status, region of residence, and stage, where appropriate. RESULTS: Compared to other breast cancer patients reported to the MCR, WHN women were just as likely to be diagnosed at an advanced stage (III or IV), treated with surgery, chemotherapy, and hormone therapy, and treated with complete mastectomy versus partial mastectomy. WHN women were less likely to receive radiation therapy (odds ratio = 0.7; 95% confidence interval = 0.6-0.9), particularly after partial mastectomy, and had a slightly longer time from diagnosis to treatment than other breast cancer patients (p < 0.01). CONCLUSIONS: Women diagnosed with breast cancer through a NBCCEDP in Massachusetts had similar stage and treatment patterns as other breast cancer patients in the state, except for the use of radiation therapy.

Adult↗

PubMedDate not supplied

Predictors of the performance of breast and cervical cancer early detection by public health nurses.

INTRODUCTION: Public health nurses (PHNs) often serve as primary care providers, yet few studies have examined their practice patterns in the early detection of breast and cervical cancer. METHODS: We conducted a cross-sectional survey of all PHNs (N = 1,894) employed by the county health departments of North Carolina in July 1993 to describe the predictors of their performance of breast and cervical cancer early detection. The main outcome measures were self-report of cancer prevention and screening services provided for their adult clients, nursing self-confidence for counseling clients about cancer prevention, and training experience. Self-confidence for counseling clients about cancer prevention was measured by asking whether a nurse had sufficient knowledge to educate clients about cancer prevention as well as by obtaining nursing perception of the quality of their clinical skills. RESULTS: The response rate was 78%. Final sample consisted of 1,369 PHNs, after exclusion of 101 nurse practitioners. Nurses reported high performance rates of cancer screening, although self-rating of the quality of their clinical skills was often low. However, nurses who reported having higher quality clinical skills or who reported having sufficient knowledge to educate clients were significantly more likely to report a greater frequency of performing cancer screening and counseling. This self-confidence and performance association was independent of nursing certification to perform screening, job classification, education, knowledge, or continuing education coursework. CONCLUSIONS: Self-confidence is a significant predictor of PHNs' reported performance of cancer screening and counseling. Further studies to verify whether self-report predicts actual performance of cancer early detection are needed.

Adult↗

PubMed1990

Early cancer detection: update for primary-care physicians.

This article highlights information about the importance of early detection of cancer in the primary care physician's office. It represents information derived from a cancer prevention reference manual, ReCap: Recommendations for Cancer Prevention, developed by the Department of Cancer Prevention and Control at The University of Texas M.D. Anderson Cancer Center. Production, evaluation, and distribution to all primary care physicians in Texas were funded by the Physician Oncology Education Program, a program of the Texas Medical Association funded by the Texas Cancer Council.

Female↗

PubMedDate not supplied

American Cancer Society guidelines for the early detection of cancer.

Each year the American Cancer Society publishes a summary of existing recommendations for early cancer detection, including updates, and/or emerging issues that are relevant to screening for cancer. In last year's article, the guidelines regarding screening for the early detection of prostate, colorectal, and endometrial cancers were updated, as was the narrative pertaining to testing for early lung cancer detection. Although none of the ACS's guidelines were updated in 2001, work is proceeding on an update of screening recommendations for breast and cervical cancer and an update of these guidelines will be announced in the January/February 2003 issue of CA. As in previous issues, we review recommendations for the "cancer-related check-up," in which clinical encounters provide case-finding and health counseling opportunities. Finally, we provide an update of the most recent data pertaining to participation rates in cancer screening by age, gender, and ethnicity from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS) and National Health Interview Survey (NHIS).

Breast Neoplasms↗