The basic approach to the control of cancer is through primary and secondary prevention. It is estimated that at least 90% of all cancers are preventable.

1. PRIMARY PREVENTION: Through advancing knowledge about the causes of some cancers, it is now possible to control these factors in the general population as well as in particular occupational groups. They include the following:

CONTROL OF TOBACCO AND ALCOHOL CONSUMPTION: Primary prevention helps to reduce the number of tobacco-related and alcohol related cancer deaths. It has been estimated that control of tobacco smoking alone would reduce the total burden of cancer by over a million cancers each year.

PERSONAL HYGIENE: Improvement in personal hygiene may help to reduce the incidence of certain types of cancer, e.g., cancer cervix.

RADIATION: special efforts should be made to reduce the amount of radiation received by each individual to a minimum without reducing the benefits.

OCCUPATIONAL EXPOSURES: Industries should take measures to protect workers from carcinogens.

IMMUNIZATION: In case of primary liver cancer, immunization against hepatitis B virus presents an exciting prospect.

FOODS, DRUGS AND COSMETICS: These should be tested for carcinogens.

AIR POLLUTION: Control of air pollution is another preventive measure.

TREATMENT OF PRECANCEROUS LESIONS: Early detection and treatment of precancerous lesions such as cervical tears, intestinal polyposis, warts, chronic gastritis and adenoma is one of the cornerstones of cancer prevention.

LEGISLATION: Legislation also has a role in primary prevention, but most likely won't happen.

2. SECONDARY PREVENTION: Secondary prevention comprises the following measures:

CANCER REGISTRATION: It provides a base for assessing the magnitude of the problem and for planning the necessary services. Cancer registries are of two types: hospital based and population based.

EARLY DETECTION OF CASES: Cancer screening is the main weapon for early detection of cancer at a pre-invasive or pre-malignant stage. Efficiency of screening programs may be increased by focusing on high-risk groups.

TREATMENT: Certain forms of cancer are amenable to surgical removal, while some others respond favorably to radiation or chemotherapy or both. Multi-modality approach to cancer control has become a standard practice in cancer centers all over the world. Today in the developed countries, cancer treatment is geared to high technology. For those who are beyond the curable stage, the goal must be to provide pain relief.



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