J. Mark Elwood - Böcker

Neural tube defects, spina bifida, anencephalus, and encephalocoele, are among the commonest severe congenital abnormalities in most countries. The last decade has seen many advances, including the use of antenatal diagnosis by chemical and ultrasound methods, population screening, and many new findings in epidemiology, culminating in the demonstration of the protective effect of folic acid on recurrences. The progress in both antenatal diagnosis and in aetiological research on neural tube defects has been particularly dramatic, and may well anticipate developments in regard to other congenital abnormalities. Primary prevention now appears as an attainable goal.This book presents a critical review of the extensive findings of epidemiological studies, discusses several methodological issues of wider relevance such as ascertainment, seasonal variation, ethical and legal issues. As well as providing a unique resource in regard to neural tube defects, much of the material is relevant to those with wider interests in the prevention, antenatal diagnosis, and control of major diseases.

Cancer control is the term applied to the development of integrated population-based approaches to reduce the incidence and mortality from cancer and to minimize its impact on affected individuals and on the community. It covers a spectrum of prevention, early diagnosis, optimal treatment, and supportive and palliative care. It emphasizes the application of new knowledge gained through research to achieve current best practice. Cancer control has become a political priority in many countries in recent years, with the evolution of both national and regional cancer control strategic plans. The integrated nature of cancer control, involving a wide spectrum of health care professionals, researchers, and health managers and planners, is reflected in this multi-disciplinary text, which is the first in this rapidly developing field.

Our series Cancer Prevention - Cancer Control continues to address the causes and prevention of cancer.

Significant progress has been made in recent years in understanding the origins of cutaneous maligant melanoma. Knowledge of the relationship between solar radiation and melanoma has changed and it now appears that both the character and timing of exposure may be more important than total cumulative dose in accounting for risk. The melanoma-sunlight model may prove an instructive heuristic exercise for environmental epidemiology, as we currently tend to restrict ourselves to a search for uniform total dose--response relationships between cancers and suspected environmental carcinogens. The study of the relationship between acquired melanocytic nevi and melanoma has led to useful new information about predictors of melanoma risk, and in addition has opened new perspectives on the development of nevi in children. Definition of the factors for nevus development in children may lead to the possibility of primary prevention programs for melanoma in younger generations of children. Recent new evidence suggests that certain occupational groups may be at elevated risk of melanoma. A great deal of work is going into the study of ways of screening high risk populations in order to detect melanoma at its earliest stages when current treatment protocols are most effective. The visibility of lesions on the skin challenges classical definitions of early detection and screening in epidemiology.