UICC Monograph Series – serie

The first edition of this Monograph on Cancer Detection was published by the Inter­ national Union Against Cancer (U.I.CC) in 1966. Since that time the Committee respon­ sible for that Monograph has gained considerable experience through the organization of a cervical screening programme in Santiago, Chile and a symposium on the evaluation of mass screening programmes in Sheffield, England. The knowledge acquired from these activities, together with the practical advice from participants and the introduction of new techniques of cancer detection have prompted the Committee to revise completely the 1966 publication. It is the hope of the International Union Against Cancer that this revision will prove helpful to all countries involved in or contemplating cancer detection programmes. As the Chairman of the Cancer Control Commission within which the Committee on Cancer Prevention and Detection functions, I take pleasure in acknowledging their dedi­ cation and effort in the preparation of this report. The Committee members are: * Dr. A. J. PHILLIPS (Chairman) - Canada Dr. D. A. BoYES - Canada Dr. M. GAITAN-YANGUAS - Colombia * Dr. R. GERARD-MARCHANT - France * Dr. J. KNOWELDEN - England Dr. B. MACMAHON - U.S.A. Dr. M. MONTERO - Chile Dr. T. MORK - Norway Dr. B. TERRACINI - Italy * editorial committee In the preparation of the report the Committee was assisted by Dr. ] OHN WAKEFIELD, a member of the UI.CC Committee on Public Education. E. C EASSON M.D.

The International Union Against Can- knowledge of what to do or how to do it; cer convened a Conference on the to identify the nature of, and reason for, Chemotherapy of Choriocarcinoma in the successful chemotherapeutic results in Baguio City, Philippines to focus atten- trophoblastic neoplasia (whether this be tion on the therapy of neoplasms of the specificity of drugs, the nature of the trophoblast. allogenic graft or characteristics of the Cures of cancer are of concern to every specific cells); and to determine the cau- man. The oldest therapy of cancer likely ses for failures (whether it be advanced consisted of herbs, potions and incanta- and long-standing disease, inappropriate tions. Cures may first have been achieved dosage regimens, or inherent resistance of in the murky annals of early civilization the tumors treated). If this first chemo- with local chemical cautery. The first therapeutically curable cancer can serve successes of surgery are lost in antiquity as a model for the chemotherapy of other and probably were amputations.Radia- autochthonous tumors, the therapeutic tion therapy was first used for cure in the principles may be useful for extrapolation early years of the 20th century. Curabil- to other tumors. Such unique maracteris- ityof the first cancer with drugs is a recent tics as the temnique of dosing and the phenomenon: choriocarcinoma in 1956.

The incidence of ovarian cancer has progressively increased during the past decade, and its mortality rate has followed a similar course. Conversely, in cancer of the uterine cervix, the mortality rate has diminished. Detection and early diag­ nosis have been the two responsible factors in achieving the decrease in the number of deaths occurring in cancer of the cervix. The revers~ is true in cancer of the ovary: diagnosis as a rule is only established late, when dissemination has already occurred, thus making the control of the disease much more difficult. Clinical staging thus far has not been in use at many centers, and it therefore becomes very difficult to compare results of treatment since we do not know the exact anatomical extent of the disease. Histopathological classification in cancer of the ovary is still a very controversial subject and a uniform terminology is urgently required. Management of patients with cancer of the ovary varies widely from one institu­ tion to another. There is no agreement as to how to treat an ovarian neoplasm; by surgery alone, or, by using radiation and chemotherapy as a complement to the operative treatment. In an effort to shed more light on these items, the Patient Care Committee of the UIce held this symposium, which was unique in the broadness of its scope pertaining to every phase of ovarian cancer.

This monograph is essentially the outcome of corporate endeavour on the part of members of the Committee on Public Education of the International Union against Cancer, from the decision taken in September 1963, via a lengthy and arduous rework­ ing of the first draft in Philadelphia in 1964 to its final editorial meeting in September 1965. In between there has been a continuous exchange of ideas, suggestions, advice and material for inclusion. Nevertheless, as chairman I should be remiss if I did not acknowledge the Committee's indebtedness to Mr. MICHAEL S. GOOD STADT, formerly of the University of Manchester, who worked with me in Manchester and undertook the painstaking search of sources of published information and compiled the draft on which this monograph is based. If there are omissions from the bibliography, it is not for want of industry in seeking them out: our difficulty has been to obtain original material from certain sources. We hope that the material assembled here will both offer useful guidance to those engaged in public education about cancer and provide a baseline from which future research in this neglected field may stem. Committee on Public Education International Union Against Cancer Chairman: JOHN WAKEFIELD, U. K. Members: Dr F. DE AMESTI, Chile, Mr. A. J. BROWN, Australia, Dr. J. COURTIAL, France, Mr. T. CRAMER, Denmark, Dr. L. MEINSMA, The Netherlands, Dr. R. A. MUSTARD, Canada, Dr. L. V. ORLOVSKY, U. S. S. R. , Dr. J. C.

The downward displacement in stomach cancer mortality among Japanese migrants to the United States and their descendants provides an opportunity to see whether the changes in risk can be associated with changes in customs, occupation or other environmental exposures traceable to migration. Case- control studies in two prefectures of Japan and in Hawaii and California undertaken with this objective in mind are described. Some preliminary results from interviewing in Miyagi prefecture on the association of selected items of diet with stomach cancer are presented and discussed. References ArRD, 1., BENTALL, H. H., and RoBERTS, J. cer in Hawaii. Milit. Med. 131, 222-223 A. F ., A relationship between cancer of (1966). stomach and the ABO blood groups. Brit. SEGI, M., and KuRrHARA, M., Cancer mor- med J. 1953 I, 799-801. tality for selected sites in 24 countries, BrLLINGTON, B. P., Gastric cancer-relation- No. 3, (1960/61). Sendai, Japan, Tohoku ships between ABO bloodgroups, site and University School of Medicine 1964. epidemiology. Lancet 1956 II, 859-862. SMITH, R. L., Recorded and expected mor- BucKWALTER, J. A., WoHLWEND, C. B., tality among J apanese of the United States CoLTER, D.C., TmRrcK, R. T., and and Hawaii, with special reference to can- KNOWLER, L. A., The association of the cer. ]. nat. Cancer lnst. 17, 459-473 ABO blood groups to gastric carcinoma. (1956).