Anthony B. Miller – författare

Screening for cancer is an important focus of cancer control. Yet screening, as it involves administering a test to large segments of the population deemed to be at risk for the disease of interest, is potentially a major consumer of scarce health care resources. In addition, the benefits sought from cancer screening, particularly reduction in mortality from the disease, are not always realized, either for biological or organizational reasons. Thus, the paradigm that "early detection must always be beneficial", taught to health care professionals, and publicized widely through the media to the public, has been challenged in the last two decades for a number of cancer sites. It is the purpose of this text to determine the extent to which the requirements for the introduction of population-based screening programmes have been met, as a result of extensive research on screening during the last two decades, with a major concentration on findings from the recent decade.

Screening for cancer is an important focus of cancer control. Yet screening, as it involves administering a test to large segments of the population deemed to be at risk for the disease of interest, is potentially a major consumer of scarce health care resources. In addition, the benefits sought from cancer screening, particularly reduction in mortality from the disease, are not always realized, either for biological or organizational reasons. Thus, the paradigm that `early detection must always be beneficial', taught to health care professionals, and publicized widely through the media to the public, has been challenged in the last two decades for a number of cancer sites. It is the purpose of Advances in Cancer Screening to determine the extent to which the requirements for the introduction of population-based screening programs have been met, as a result of extensive research on screening during the last two decades, with a major concentration on findings from the recent decade.

Screening for cancer is an important focus of cancer control. Yet screening, as it involves administering a test to large segments of the population deemed to be at risk for the disease of interest, is potentially a major consumer of scarce health care resources. In addition, the benefits sought from cancer screening, particularly reduction in mortality from the disease, are not always realized, either for biological or organizational reasons. Thus, the paradigm that `early detection must always be beneficial'', taught to health care professionals, and publicized widely through the media to the public, has been challenged in the last two decades for a number of cancer sites. It is the purpose of Advances in Cancer Screening to determine the extent to which the requirements for the introduction of population-based screening programs have been met, as a result of extensive research on screening during the last two decades, with a major concentration on findings from the recent decade.

Epidemiologic Studies in Cancer Prevention and Screening is the first comprehensive overview of the evidence base for both cancer prevention and screening. This book is directed to the many professionals in government, academia, public health and health care who need up to date information on the potential for reducing the impact of cancer, including physicians, nurses, epidemiologists, and research scientists. The main aim of the book is to provide a realistic appraisal of the evidence for both cancer prevention and cancer screening. In addition, the book provides an accounting of the extent programs based on available knowledge have impacted populations. It does this through: 1. Presentation of a rigorous and realistic evaluation of the evidence for population-based interventions in prevention of and screening for cancer, with particular relevance to those believed to be applicable now, or on the cusp of application 2. Evaluation of the relative contributions of prevention and screening 3. Discussion of how, within the health systems with which the authors are familiar, prevention and screening for cancer can be enhanced. Overview of the evidence base for cancer prevention and screening, as demonstrated in Epidemiologic Studies in Cancer Prevention and Screening, is critically important given current debates within the scientific community. Of the five components of cancer control, prevention, early detection (including screening) treatment, rehabilitation and palliative care, prevention is regarded as the most important. Yet the knowledge available to prevent many cancers is incomplete, and even if we know the main causal factors for a cancer, we often lack the understanding to put this knowledge into effect. Further, with the long natural history of most cancers, it could take many years to make an appreciable impact upon the incidence of the cancer. Because of these facts, many have come to believe that screening has the most potential for reduction of theburden of cancer. Yet, through trying to apply the knowledge gained on screening for cancer, the scientific community has recognized that screening can have major disadvantages and achieve little at substantial cost. This reduces the resources that are potentially available both for prevention and for treatment.

Epidemiologic Studies in Cancer Prevention and Screening is the first comprehensive overview of the evidence base for both cancer prevention and screening. This book is directed to the many professionals in government, academia, public health and health care who need up to date information on the potential for reducing the impact of cancer, including physicians, nurses, epidemiologists, and research scientists. The main aim of the book is to provide a realistic appraisal of the evidence for both cancer prevention and cancer screening. In addition, the book provides an accounting of the extent programs based on available knowledge have impacted populations. It does this through: 1. Presentation of a rigorous and realistic evaluation of the evidence for population-based interventions in prevention of and screening for cancer, with particular relevance to those believed to be applicable now, or on the cusp of application 2. Evaluation of the relative contributions of prevention and screening 3. Discussion of how, within the health systems with which the authors are familiar, prevention and screening for cancer can be enhanced. Overview of the evidence base for cancer prevention and screening, as demonstrated in Epidemiologic Studies in Cancer Prevention and Screening, is critically important given current debates within the scientific community. Of the five components of cancer control, prevention, early detection (including screening) treatment, rehabilitation and palliative care, prevention is regarded as the most important. Yet the knowledge available to prevent many cancers is incomplete, and even if we know the main causal factors for a cancer, we often lack the understanding to put this knowledge into effect. Further, with the long natural history of most cancers, it could take many years to make an appreciable impact upon the incidence of the cancer. Because of these facts, many have come to believe that screening has the most potential for reduction of theburden of cancer. Yet, through trying to apply the knowledge gained on screening for cancer, the scientific community has recognized that screening can have major disadvantages and achieve little at substantial cost. This reduces the resources that are potentially available both for prevention and for treatment.

Epidemiologic Studies in Cancer Prevention and Screening is the first comprehensive overview of the evidence base for both cancer prevention and screening. This book is directed to the many professionals in government, academia, public health and health care who need up to date information on the potential for reducing the impact of cancer, including physicians, nurses, epidemiologists, and research scientists. The main aim of the book is to provide a realistic appraisal of the evidence for both cancer prevention and cancer screening. In addition, the book provides an accounting of the extent programs based on available knowledge have impacted populations. It does this through: 1. Presentation of a rigorous and realistic evaluation of the evidence for population-based interventions in prevention of and screening for cancer, with particular relevance to those believed to be applicable now, or on the cusp of application 2. Evaluation of the relative contributions of prevention and screening 3. Discussion of how, within the health systems with which the authors are familiar, prevention and screening for cancer can be enhanced. Overview of the evidence base for cancer prevention and screening, as demonstrated in Epidemiologic Studies in Cancer Prevention and Screening, is critically important given current debates within the scientific community. Of the five components of cancer control, prevention, early detection (including screening) treatment, rehabilitation and palliative care, prevention is regarded as the most important. Yet the knowledge available to prevent many cancers is incomplete, and even if we know the main causal factors for a cancer, we often lack the understanding to put this knowledge into effect. Further, with the long natural history of most cancers, it could take many years to make an appreciable impact upon the incidence of the cancer. Because of these facts, many have come to believe that screening has the most potential for reduction of theburden of cancer. Yet, through trying to apply the knowledge gained on screening for cancer, the scientific community has recognized that screening can have major disadvantages and achieve little at substantial cost. This reduces the resources that are potentially available both for prevention and for treatment.

The European School of Oncology came into existence to respond to a need for information, education and training in the field of the diagnosis and treatment of cancer. There are two main reasons why such an initiative was considered necessary. Firstly, the teaching of oncology requires a rigorously multidiscipli­ nary approach which is difficult for the Universities to put into practice since their system is mainly disciplinary orientated. Secondly, the rate of technological development that impinges on the diagnosis and treatment of cancer has been so rapid that it is not an easy task for medical faculties to adapt their curricula flexibly. With its residential courses for organ pathologies and the seminars on new techniques (laser, monoclonal antibodies, imaging techniques etc.) or on the principal therapeutic controversies (conservative or mutilating surgery, primary or adjuvant chemotherapy, radiotherapy alone or integrated), it is the ambition of the European School of Oncology to fill a cultural and scientific gap and, thereby, create a bridge between the University and Industry and between these two and daily medical practice. One of the more recent initiatives of ESO has been the institution of permanent study groups, also called task forces, where a limited number of leading experts are invited to meet once a year with the aim of defining the state of the art and possibly reaching a consensus on future developments in specific fields of on­ cology.