Index*
A
Access to services, 152
distribution of cancer burden and, 8, 12–13, 22, 425, 433–434
obstacles to cancer screening participation, 225, 231–232, 243, 410, 436
recommendations for improving, 7, 8, 423–424, 425
Advertising of tobacco products, 4, 412
Agency for Healthcare Policy and Research, 99, 105
Agency for Healthcare Research and Quality, 10, 218, 334, 335
clinician training programs, 328
Evidence-Based Practice Centers, 384
guidelines development and dissemination, 384–387
Preventive Services Task Force, 10–11, 228, 275, 333–334, 387, 428– 430
Quality Interagency Coordination Task Force, 388
recommendations for, 10–11, 12, 428
research activities, 384–388
Task Force on Community Preventive Services, 334, 428, 429, 430
Translating Research into Practice, 387
weight-loss program evaluations, 139, 140t, 141t, 142, 143, 144
cancer risk, 22
implications for provider education and training, 296
See also Elderly patients
Alcohol consumption
alcohol types, 82–83
associated cancer risk, 82–83, 83t
breast cancer and, 84
carcinogenic action, 83–84
colorectal cancer and, 84–85
health effects, 81–82
liver cancer and, 84
lung cancer and, 85
oropharyngeal/laryngeal/esophageal cancer risk, 83–84
potential effectiveness of cancer prevention, 1, 36, 400–401
predictive modeling of cancer reduction, 32–33
sociodemographic patterns, 85
Alliance, The, 422–423
Alpha-Tocopherol Beta Carotene Cancer Prevention Study Group, 79–80
American Academy of Family Physicians, 215
American Association for Cancer Education, 302f, 306
American Association of Health Plans, 329– 330
American Association of Medical Colleges, 301–303, 302f, 304–305
American Cancer Society, 13, 183, 306, 421
Cancer Prevention Studies, 43f, 45–46, 50, 52–53, 54
cancer reduction goals, 33, 34–35t
clinician training programs, 328–329
screening guidelines, 228, 274–275
American College of Physicians, 215
American College of Radiology, 286–287, 288
American Gastroenterological Association, 183
American Legacy Foundation, 330, 394– 395
American Lung Association, 97, 317
American Society of Preventive Oncology, 302–303f
American Urological Association, 215
Anti-Lung Cancer Action, 277, 283
Association of American Medical Colleges, 426
Association of Teachers of Preventive Medicine, 302f, 303, 305
B
Barium enema, 179
Behavioral interventions
conceptual models of change processes, 89–92
effectiveness, 2, 87, 153–155, 407
health care system implementation, 148– 153
to improve eating habits, 138–145
to improve physical activity, 111, 113– 120
to improve screening participation, 244– 250
incentive programs, 132
latency of effects, 39
predictive modeling, 32–33, 37, 38
public education campaigns, 11–12, 432
risk factor counseling, 345t
service delivery strategies, 87–89
smoking cessation programs, 93–101
weight-loss programs, 127–129
Behavioral Risk Factor Surveillance System, 57
Benzene, 52
fruit and vegetable consumption and, 68–69
Body mass index, 65–66
Breast biopsy, 197
Breast cancer
alcohol consumption and, 84
carotenoid consumption and, 79
clinician education for early detection, 324–325
dietary fat intake and, 77
fruit and vegetable consumption and, 69
incidence, 19
physical activity and, 58, 60, 402
potential effectiveness of preventive intervention, 1, 36, 37
quality of preventive services, 9
risk factors, 25–26
screening, 6, 7, 37, 158, 351–352, 403, 424
breast self-examination, 195–196
clinical breast examination, 186–187
cost-effectiveness, 198–199
DCIS detection, 186
effectiveness of early detection, 188– 194
mammography, 403
Medicare coverage, 355
modalities, 186–187
for older women, 194
potential harms, 196–198
practice guidelines, 203–204f, 223
public awareness and understanding, 240–241, 242–243, 245, 246
strategies for improving, 244–250
subjective value judgments in, 199– 203
selenium intake and, 80
British male doctors study, 43f, 46, 47
Bronchoscopy, 285–286
Bupropion, 98–100
C
Calcium, 76
Canadian Breast Cancer Screening Initiative, 187, 192–193
Cancer Intervention and Surveillance Modeling Network, 38–39
Carbohydrates, 77
weight-loss programs, 122, 123–124
Cardiovascular disease, 17
diet and, 66
physical activity and, 58, 114
physical activity regimen to prevent, 111
Cardiovascular Health in Children, 143– 144
Carotenoids, 50, 69, 71, 79–80
Case finding, 156
Case management, 250
CATCH. See Child and Adolescent Trial for Cardiovascular Health
Causes of cancer, 27–28, 31–32, 401–403
bladder cancer, 47–48
breast cancer, 58, 60, 62, 84, 402
cervical cancer, 51
colon cancer, 49–50, 59–60, 63
colorectal cancer, 58, 62, 72–73, 78–79, 84–85
endometrial cancer, 53, 62, 402
esophageal cancer, 64, 67, 402
kidney cancer, 48, 63, 74, 402
laryngeal cancer, 67
leukemia, 52
oropharyngeal cancer, 46–47, 67, 83–84
prostate cancer, 53, 62, 73–74
red meat consumption, 72–74
See also Lifestyle factors;
Smoking-related cancer
Centers for Disease Control and Prevention, 3, 10, 11, 256, 334, 435
cancer screening programs, 7–8, 351– 352, 424
Center for Chronic Disease Prevention and Health Promotion, 418
clinician education programs, 324–326
data collection activities, 337–338
information dissemination activities, 336
Office of Smoking and Health, 418
recommendations for, 5, 7–8, 410–411, 418–419, 424
research activities, 381–384, 398–399
school diet and nutrition guidelines, 417
state programs, 338–340, 341, 418–419
Centers for Medicare and Medicaid Services, 9, 256, 388–390, 425
See also Medicaid;
Medicare
Cervical cancer, 350–351
clinician education for early detection, 324–325
epidemiology, 27
fruit and vegetable consumption and, 71–72
mortality, 27
potential effectiveness of preventive intervention, 1, 403
screening, 6, 7, 158, 171, 218–220, 221f, 223, 253–255, 351, 403
Chemoprevention, 17
Child and Adolescent Trial for Cardiovascular Health (CATCH), 117, 137, 144
Church-based programs, 119, 147, 247f
Clonidine, 98
Cochrane Collaboration, 190, 229, 395– 396, 397f
Cognitive functioning
medical attitudes and beliefs, 230–231, 241
models of behavior change, 89–92
Colonoscopy, 179–180, 181, 182, 183–185, 233, 234, 237
Colorectal cancer
alcohol consumption and, 84–85
clinician education for early detection, 325–326
epidemiology, 26–27
folate intake and, 78–79
fruit and vegetable consumption and, 69–70
glucose metabolism and, 80–81
incidence, 19
physical activity and, 58, 59–60
potential effectiveness of preventive intervention, 1, 36, 37
public awareness and understanding, 235, 236
red meat consumption and, 72–73
screening, 6, 7–8, 11, 223, 226, 359t, 403, 421, 424, 429
effectiveness, 175
fecal occult blood testing, 176–177, 181, 182–183, 233, 234, 235, 237, 238
future demand, 296
of Medicare beneficiaries, 296
sigmoidoscopy, 178–179, 180, 181, 182–183, 233, 234, 235, 296
techniques, 175
selenium intake and, 80
whole-grain food consumption and, 75
Community Health Centers, 7, 342–344, 423, 424
Community-level interventions, 2, 87–88
clinical training for, 300
to improve eating habits, 144–145, 147
local administration of, 107
monitoring effectiveness of, 11, 430
obstacles to cancer screening participation, 226–227
physical fitness promotion, 118, 120
policy effects, 107
smoking cessation, 105–108
smoking prevention, 110
weight-loss programs, 133
Computed tomography, 276
cancer screening, 11
helical, 260, 276–291, 292–293
Computerized Needs-Oriented Quality Measurement Evaluation System, 335, 387
Continuing medical education, 9, 319–322
Cost-benefit analysis, 170
Cost-effectiveness analysis, 170–171
Cost-utility analysis, 171
Costs
cancer care, 20
as determinant of intervention outcomes, 102
insurance coverage for prevention efforts, 6–7, 421–423
lung cancer screening, 288, 290
obstacles to cancer screening participation, 225, 232
screening, 169–171, 181–182, 198–199, 213, 220, 222
smoking cessation programs, 105, 411
social costs of cancer, 20
state cancer control plans, 5
D
Dairy product consumption, 75–77
DCIS. See Ductal carcinoma in situ
Demographic patterns
alcohol use, 85
cancer burden distribution, 20–22
cancer screening participation, 239–240, 257
diet-related cancer risk, 81
See also Elderly patients;
Race/ethnicity;
Socioeconomic status
Dental schools, 316–317
Department of Defense, 13, 390–391
Department of Health and Human Services, 12–13, 352, 383–384, 433
evaluation of federal prevention services, 8, 10–11, 424–425, 428–430
recommendations for, 4, 8, 10–11, 414, 424–425, 428–430
research programs, 371–381
Department of Veterans Affairs, 338, 391– 392
Dexfenfluramine, 131
Diagnostic testing, 156
Diet and nutrition, 86
cancer risk and, 402–403
fruits and vegetables, 66–72, 81
glucose metabolism, 80–81
interventions to improve eating habits, 133–134, 138–148
macronutrients, 77, 78t, 122–123
milk and dairy products, 75–77
potential effectiveness of cancer prevention, 1, 30, 36, 400–401
predictive modeling of cancer reduction, 33
recommendations for cancer prevention strategies, 4, 409, 414, 417
recommended daily intake, 138
red meat consumption, 72–74, 81
role of health care providers, 149–150
sociodemographic patterns, 71–72, 81
training of health care providers in, 309–312
weight guidelines, 65–66
whole-grain foods, 74–75
See also Weight-loss programs
Ductal carcinoma in situ (DCIS), 186
E
Early Lung Cancer Action Project, 277, 287, 288
Education and training of health care providers
administrators, 295
in clinical nutrition, 309–312
continuing education, 9, 319–322, 426
dental schools, 316–317
in exercise counseling, 312–313
for graduate medical students, 311–313
nonphysician providers, 10, 428
nursing schools, 313–316
opportunities for improving, 330–331
for physical fitness promotion, 114
potential shortage of medical personnel, 10, 296, 297, 311, 428
private resources and programs, 328– 330
public resources and programs, 322–328
recommendations, 8–10, 425–428
in screening practices, 227–228
in smoking cessation, 307–309
types of providers in need of training, 295–298
undergraduate medical student training, 301–311
Educational attainment
cancer screening participation and, 239, 253
diet-related cancer risk and, 81
smoking risk and, 57
Effectiveness of preventive interventions
ancillary health benefits, 40
behavioral strategies, 2
characteristics of successful programs, 153–155, 407
clinical vs. public health interventions, 88–89
community-level interventions, 105, 107–108, 118, 120, 133, 144– 145
family-based interventions, 135–136
fruit and vegetable consumption, 66–72
goal-setting, 39
group interventions, 97
in health care settings, 151–152
to improve eating habits, 142–145
with minority populations, 108–109, 134–135, 147–148
pharmacological interventions, 98–99
physical fitness programs, 58, 59–61, 113, 114–115, 117, 118, 119– 120
physician involvement and, 96–97
potential, 1, 15, 28, 30, 400–401, 403
predictive models, 30–40
priority setting in clinical practice, 255– 257
program cost as factor in, 102
program impact, 88–89
prostate cancer, 208–211
recommendations for evaluation of, 9– 11, 427–430
recommendations for improving, 3–13, 410–432
research needs for improving, 13, 434
residential treatment programs, 97–98
school-based programs, 117, 119–120, 143–144
screening, 37, 161–167, 174–175, 403, 406–407
breast cancer, 188–196
improving participation, 236–238, 244–250, 254–255, 258
lung cancer, 261–264, 265–274, 277–282, 283–286, 292
measuring, 270
self-help interventions, 96
smoking cessation, 44–46, 47, 48, 49, 50, 51, 52–53, 93–101, 105, 107
smoking prevention campaigns, 109–111
systems of care as factor in, 9, 426–427
whole-grain food consumption, 74–75
worksite programs, 100–101, 132, 142– 143
Elderly patients
cancer screening participation, 232, 240, 241, 242
See also Aging of population
Endometrial cancer, 53
fruit and vegetable consumption and, 71
screening, 161–162
Environmental risk factors, 31–32
social cognitive theory, 91
tobacco smoke exposure, 53–54, 413f
alcohol consumption and, 83–84
fruit and vegetable consumption and, 67
Estrogen metabolism, 53, 60, 62, 84
Ethics issues in screening, 167–169
Evaluation of prevention services, 8, 9–11, 427–430
Exercise and physical activity, 86
behavior change interventions, 111, 113–120
cancer risk reduction, 58–61, 58t, 402
colon cancer and, 59–60
community-level programs, 118
current patterns of, 405
health benefits, 58
health care provider role in promoting, 114, 150
lung cancer and, 60
obstacles to, 405–406
policy interventions to promote, 119
potential effectiveness in cancer prevention, 1, 30, 400–401
predictive modeling of cancer reduction, 33
programs in health care settings, 113– 115
programs to reach minority populations, 119–120
prostate cancer and, 60–61
recommendations for cancer prevention strategies , 4, 409, 414–415f, 416– 417
recommended daily levels, 111
school-based programs, 116–117
terminology and measurement, 111–112
training of health care providers in, 312–313
transportation infrastructure and, 6, 119, 381, 416
weight-loss programs, 124–127, 136–137
worksite programs for promoting, 115, 116t
F
Family-level interventions
smoking prevention, 110
weight loss, 135–136
interventions to improve eating habits, 138–144, 145, 147
weight-loss programs, 122–124
Fecal occult blood testing, 176–177, 177t, 181, 182–183, 233, 234, 235, 237, 238
Federal government
cancer prevention activities, 8, 332, 364, 425
clinical guideline development, 332–335
data collection activities, 336–338
direct delivery of services, 342–352
employee health benefits, 423
evaluation of prevention services, 8, 10– 11, 424–425, 428–430
indirect service delivery, 352–364
information dissemination activities, 335–336
research activities, 368, 398–399
role in improving access of underserved populations to medical services, 7, 423–424
smoking cessation strategies, 3–4, 410– 412
support for community-based programs, 5
See also specific agency;
specific program
Fenfluramine, 131
Fluorescent bronchoscopy, 285–286
FRAMES, 92
Fruit and vegetable consumption, 81
bladder cancer and, 68–69
breast cancer and, 69
cervical cancer and, 71–72
colon cancer and, 69–70
cruciferous vegetables, 70
endometrial cancer and, 71
health benefits, 66
interventions to improve eating habits, 138–148
kidney cancer and, 72
liver cancer and, 72
lung cancer and, 69
oropharyngeal/esophageal/laryngeal cancer and, 67
ovarian cancer and, 70
pancreatic cancer and, 68
stomach cancer and, 67–68
thyroid cancer and, 71
G
Gastroesophageal reflux, 64
Genetic susceptibility
breast cancer, 25–26
screening, 168–169, 195, 197–198
Gimme 5 program, 143
Glucose metabolism, 80–81
Go Girls! Program, 120
Group Health Cooperative, 102, 154f
Group interventions, 97
H
Health belief model, 89–90
Health Care Financing Administration. See Centers for Medicare and Medicaid Services
Health care providers
access of underserved populations, 7, 423–424
assessment systems, 150–151
in behavior risk reduction, 148–152
in delivery of screening services, 227– 230, 242, 409
in diet and nutrition management, 149– 150
in promoting physical fitness, 113, 114, 150
research on clinical practice, 374
in smoking cessation interventions, 94, 96–97, 149, 155
See also Education and training of health care providers
Health maintenance organizations, 152– 153, 154f, 225, 243
quality of care, 379
Health Professional Follow-Up Study, 43f, 49
Health promotion, 28–29
Health Resources and Services Administration, 305
cancer prevention programs, 342–344
clinician training programs, 10, 326– 328, 428
Health risk appraisals, 151
Health-seeking behaviors, 89–90
cost of care and, 102
dental care, 316
medical attitudes and beliefs, 230–231, 241
See also Participation in cancer screening
Healthy People 2010, 12–13, 97, 113, 149, 253, 298f, 332–333, 364, 413f, 430, 433
Helicobacter pylori, 50
Hormonal system, obesity and, 62
Human papilloma virus, 51
screening, 218–219
Hypertension, 66
I
Immigrant populations, 243
Incentives for change, 132
Incidence of cancer, 19–20, 21t, 31
bladder cancer, 47–48
breast cancer, 25
colorectal cancer, 26–27
endometrial cancer, 52–53
kidney cancer, 48
leukemia, 52
oropharyngeal cancer, 46
potential effectiveness of preventive intervention, 1, 30, 403
predictive modeling of prevention intervention outcomes, 31–40
stomach cancer, 50
Indian Health Service, 349–351
Insulin-like growth factor, 63
Insurance
coverage for prevention efforts, 6–7, 421–423
smoking cessation interventions, 101–102
trends, 225–226
obstacles to cancer screening participation, 225, 231–232, 237, 243–244
population coverage, 225
underserved populations, 7–8, 12, 423– 424
International Agency for Research on Cancer, 4, 32, 58, 62, 414
Internet programs
cancer information programs, 335–336, 341
continuing medical education, 319–320
weight-loss programs, 130
Internet sales of controlled products, 3
Intravenous drug use, 17
J
Joint Commission on the Accreditation of Healthcare Organizations, 10, 427
Jump Into Action Program, 117
K
dairy product consumption and, 76
fruit and vegetable consumption and, 72
red meat consumption and, 74
L
Lactose, 76–77
alcohol consumption and, 83–84
fruit and vegetable consumption and, 67
Legislative action
cancer screening standards, 226
latency of effects, 39
smoking cessation strategies, 3–4
tobacco control efforts, 103–104f, 107– 108, 110–111, 411–412
Leukemia, 52–53
Lifestyle factors
evidence for cancer association, 41–42, 42f, 43f
health behavior trends, 2
maintenance of weight loss, 126
potential effectiveness of cancer prevention, 1, 403
significance of, 31–32, 41, 85–86
See also Behavioral interventions
Lifetime probability of cancer onset, 19–20
cervical cancer, 27
lung cancer, 25
prostate cancer, 26
Live for Life program, 115
Liver cancer
alcohol consumption and, 84
fruit and vegetable consumption and, 72
Lose Weight and Win Program, 119
Lung cancer, 44
alcohol consumption and, 85
carotenoid consumption and, 79–80
causes, 25
from environmental tobacco smoke exposure, 53–54
epidemiology, 25
fruit and vegetable consumption and, 69
lifetime probability, 25
mortality and morbidity, 25, 259
physical activity and, 60
potential effectiveness of preventive intervention, 1
bronchoscopy, 285–286
false-negatives, 273
future directions, 286–291, 296
guidelines, 274–276
informed consent, 289
potential for harm, 282, 284–285
radiography, 259, 261–274, 275
spiral computed tomography, 260, 276–291, 292–293
sputum cytology, 264, 265–271, 275, 285–286
technical development, 291–292
smoking-related, 45–46, 54, 401–402
sociodemographic patterns, 25
Lycopene, 71
M
Mammography, 187–188, 196–197, 223, 403
Medicare coverage, 355
standards of care, 226
utilization, 225–226, 238–250, 357– 358t
Mammography Quality Standards Act, 226
Managed care, 10, 101–102, 152–153, 225, 427
Medicaid enrollment, 360–361
Mass media
antismoking campaigns, 105
coverage of medical research, 11, 431
physical fitness promotion, 120
Medicaid, 8, 101, 232, 343, 359–361, 364, 425
pharmacotherapy coverage, 362–363t
Medicare, 8, 101, 153, 364, 425
enrollment, 354
preventive services, 225, 226, 237, 296– 297, 355–358
smoking cessation program coverage, 358–359
spending, 354
MESH headings, 368–369
Methionine, 85
Migrant Health Centers, 7, 342–344, 423, 424
Migrant populations, 31
Minnesota Heart Health Program, 118, 133, 145
Mortality and morbidity
alcohol consumption effects, 81–82
bladder cancer, 47
breast cancer, 25
screening effectiveness, 187, 189– 194, 403
colorectal cancer, 27, 233, 403
distribution by cancer type, 19, 19f, 20f, 21t, 29
distribution by cause, 18t
distribution by sex, 18t
effects of screening, 161–167, 256–257, 261–264, 265–272, 403
esophageal cancer, 46
kidney cancer, 48
laryngeal cancer, 46
lung cancer, 25, 259, 261–264, 265– 272, 401
need for screening, 157–158
oropharyngeal cancer, 46–47
pancreatic cancer, 49
physical activity related to, 58
potential effectiveness of preventive intervention, 1, 400–401, 403
predictive modeling of prevention intervention outcomes, 31–40
screening effectiveness, 208–209, 213–214
treatment outcomes, 209–211
smoking cessation effects, 44–46, 47, 48, 401–402, 404
sociodemographic distribution, 12–13, 20–22, 23t, 24t, 433
stomach cancer, 50
Motivational interviewing, 92
N
National Cancer Institute, 13, 46, 286–287, 334, 364
breast cancer screening guidelines, 200, 203
Cancer Education Survey, 306
cancer reduction goals, 33, 34–35t
clinician education programs, 322–324
Community Intervention Trial for Smoking Cessation, 105
data collection activities, 336–337, 379– 380
Division of Cancer Control and Population Sciences, 375, 376f
health disparities research, 13, 433–434
information dissemination activities, 335–336, 430, 432
predictive modeling of cancer reduction, 33, 38–39
Prostate, Lung, Colorectal, and Ovarian trial, 178
research activities, 371–380, 398
state programs, 340
National Cancer Policy Board, 15–16
National Council of State Boards of Nursing, 314
National Dialogue on Cancer, 421
National Family Planning Program, 352
National Governors Association, 341
National Health and Nutrition Examination Survey, 64–65
National Health Interview Survey, 57, 336– 337
National Heart, Lung, and Blood Institute, 121, 123, 124–125
National Human Genome Research Institute, 380–381
National Institute of Nursing Research, 380
National Institute on Aging, 380
National Institute on Drug Abuse, 380
National Institutes of Health, 13, 174, 433
breast cancer screening guidelines, 200– 201
prostate cancer screening guidelines, 215–216
research activities, 371–381
National Library of Medicine, 368
National Lung Screening Study, 286
National Polyp Study, 175
National Technical Assistance Office, 330
National Weight Control Registry, 125
New York Academy of Medicine, 310
Next Step Trial, 142–143
Nicotine replacement therapy, 98–100
North Karelia project, 145
Nortriptyline, 98
Number-needed-to-screen, 167
Number-needed-to-treat, 167
Nurses, 296
cancer prevention activities, 313–314
smoking cessation training, 315–316
training, 313, 314–316, 328–329
Nurses’ Health Study, 43f, 49, 78–79
O
associated cancer risk, 61–62, 61t, 402
endometrial cancer and, 62, 402
esophageal cancer and, 64, 402
health risks, 61
pharmacological treatments, 130–131
prostate cancer and, 62
recommendations for cancer prevention strategies, 4, 414–415f, 416–417
weight guidelines, 65–66
See also Weight-loss programs
Occupational disease, 31–32, 57
Office of Disease Prevention and Health Promotion, 4
Office of Family Planning, 352
Office of Management and Budget, 361– 364
alcohol consumption and, 83–84
dentist role in prevention, 316–317
fruit and vegetable consumption and, 67
smokeless tobacco use and, 54
Orlistat, 131
Oslo Youth Study, 117
Osteoporosis, 17
Outcomes measurement, 165–167, 379– 380, 391–392
Ovarian cancer
dairy product consumption and, 76–77
fruit and vegetable consumption and, 70
P
Pacific Business Group on Health, 422
fruit and vegetable consumption and, 68
red meat consumption and, 74
Pap smears, 218, 219, 226, 253, 350–351, 353t
Participation in cancer screening, 224
breast cancer, 225–226, 238–250
clinician factors, 227–230
colorectal cancer testing, 233–238, 234f
community factors, 226–227
health care system characteristics and, 225–227, 410
insurance coverage and, 225–226, 231– 232
patient factors, 230–233
prostate cancer, 251–252
strategies for improving, 229–230, 252, 254–255, 258, 409–410
breast cancer, 244–250
colorectal cancer, 236–238
Partnering with Employers for Prevention, 383
Partnership for Prevention, 256, 423
Patient role in medical decision-making, 12, 172–173, 299, 431
colorectal screening, 182–183
participation in cancer screening, 230– 233
prostate cancer screening, 215
Pawtucket Heart Health Program, 118, 133
Pharmacological interventions
Medicaid coverage, 362–363t
obesity, 130–131
for smoking cessation, 6, 98–99, 421
Pharyngeal cancer, 44, 46–47, 54
alcohol consumption and, 83–84
fruit and vegetable consumption and, 67
Physical activity. See Exercise and physical activity
Physician-Based Assessment and Counseling, 114
Physicians. See Health care providers
Planet Health, 137–138
Population attributable risk, 36
Predictive modeling of cancer reduction, 31–40
Prevention Curriculum Assistance Program, 303
Preventive Services Task Force. See Agency for Healthcare Research and Quality, Preventive Services Task Force
Project LEAN, 145
PROJECT WALK, 120
Prostaglandins, 59–60
Prostate biopsy, 211–212
Prostate cancer
dairy product consumption and, 76
epidemiology, 26
lifetime probability of, 26
mortality, 26
obesity, 62
overdiagnosis, 207
potential effectiveness of preventive intervention, 36
red meat consumption and, 73–74
antigen testing, 11, 205–208, 211, 213, 214, 251, 252
decision to implement, 213–217
effectiveness of early detection, 208– 211, 429
insurance coverage, 226
potential harms of, 211–213
practice guidelines, 215–217, 216– 217f, 223, 252
schedule, 206
utilization, 251–252
selenium intake and, 80
surgical complications, 212–213
treatment outcomes, 209–211, 214
vitamin E and, 80
Prostate, Lung, Colorectal, and Ovarian study, 286
Protein, dietary, 77
Public awareness and understanding
antismoking campaigns, 105, 110–111
breast cancer screening, 240–241, 242– 243
cancer screening participation and, 230, 245, 246
delivery of behavioral interventions, 88
federal government initiatives, 335–336
lung cancer screening, 287–288
of medical research, 12, 431–432
NCI research activities, 376–378
physical fitness programs, 118
recommendations for educational interventions, 11–12, 430–432
Public Health Service Act. See Title X (Public Health Service Act)
PubMed database, 368–369
Q
Quality assurance, 151
in cancer screening, 226
in delivery of preventive services, 9–10, 427–428
Medicare mechanisms, 354
R
Race/ethnicity
alcohol consumption patterns, 85
breast cancer risk, 26
cancer prevention research, 374–375, 382
cancer screening participation, 239–240, 241, 243, 246, 253, 254, 257, 350
cervical cancer risk, 51
colorectal cancer risk, 26–27
colorectal cancer screening, 234
diet-related cancer risk, 81
dietary patterns, 81
health attitudes and beliefs, 230–231, 241
kidney cancer risk, 48
leukemia risk, 52
lung cancer risk, 25
oropharyngeal cancer risk, 46
pancreatic cancer risk, 49
physical fitness interventions, 117, 118
programs to improve eating habits, 146, 147
prostate cancer risk, 26
smoking cessation, 57, 108–109
stomach cancer risk, 50
tobacco use patterns, 55–56, 405
weight-loss interventions, 134–135
Rehabilitation, 28
Research, 13
cancer screening, 372–373, 382, 389, 436–437
community-based interventions, 373, 383–384
current state, 365
determinants of effectiveness, 13, 434
on effectiveness of screening, 164–167
health services, 366
informational resources, 370–371
interdisciplinary, 366–367
model programs, 396–398
organizational sponsors, 13, 367–368
See also specific organization
outcomes measures, 165–167
physical activity, 372, 381, 435–436
private sponsors of, 392–398, 395t
provider practices, 374
on public awareness and understanding, 376–378
public understanding of, 12, 431–432
publishing trends, 368–369
quality of care, 379
special populations, 378–379, 382, 388
spending, 398–399
translational, 365, 366–367, 396–398
Residential treatment
smoking cessation programs, 97–98
Rice, 74–75
Robert Wood Johnson Foundation, 393–394
S
School-based programs
to improve eating habits, 143–144, 417
physical fitness, 116–117, 119–120, 416–417
for weight loss, 137–138
Screening, 17
absolute benefit, 157–158, 166–167
accuracy, 158
breast cancer. See Breast cancer, screening
Centers for Disease Control and Prevention programs, 7–8, 351– 352, 424
cervical cancer, 6, 7, 158, 171, 218–220, 221f, 223, 253–255, 403, 421
clinician compliance with guidelines, 229
colorectal cancer. See Colorectal cancer, screening
costs, 169–171, 181–182, 198–199, 220, 222
decision to implement, 171–174, 182– 183
effectiveness of early detection, 161–167, 208–211, 222, 259
evaluation of effectiveness, 11, 429
false-positive/false-negative results, 168– 169
genetic risk, 168–169, 195, 197–198
human papilloma virus, 218–219
insurance coverage, 6, 421, 422–423
lung cancer. See Lung cancer, screening
medical decision-making, 12
Medicare coverage, 355–358, 356t
overuse, 257–258
participation in. See Participation in cancer screening
patient records, 229
potential effectiveness, 1, 37, 257, 401, 406
potential for harm, 167–169, 180–181, 211–213, 219, 222
practice guidelines, 174–175, 183–185, 203–204f, 216–217f, 221t, 222– 223, 346t
predictive value, 159–161, 160t
prevalence of disease and need for, 157– 158
principles of effectiveness, 157, 409
priority setting in clinical practice, 255– 257
prostate cancer. See Prostate cancer, screening
public health challenges, 224
public understanding, 11–12, 431
regulatory standards, 226
research, 372–373, 382, 389, 436–437
skin cancer, 174
specificity, 159
terminology, 156–157
test performance evaluation, 159f
utilization, 225–226, 353t, 406–407
Seattle 5 a Day Worksite Program, 143
Selenium, 80
Self-efficacy beliefs, 90
Self-help programs, for smoking cessation, 96
Settings for interventions
behavioral interventions, 87–89
church-based programs, 119, 147, 247f
health care settings, 113–115, 140–141, 148–153
implications for provider education and training, 295–296, 300
nurse employment patterns, 314
screening tests, 247
See also Community-level interventions;
School-based programs;
Worksite intervention
Sexually transmitted disease, 27
Sibutramine, 131
Sigmoidoscopy, 178–179, 180, 181, 182– 183, 233, 234, 235, 237, 296
weight-loss programs, 127
Skin cancer, 80
screening, 174
cancer risk reduction, 45–46, 47, 48, 49, 50, 51, 52–53, 401–402
characteristics of successful programs, 93–96, 154f
community-level interventions, 105–108
cost-effectiveness of, 105
dentist role in, 316–317
education and training of health care providers for, 307–309
effectiveness of behavioral interventions, 94, 95t, 96–101
future demand for services, 297
group interventions, 97
health benefits, 44–45
health care providers involved in, 297
insurance coverage for, 6, 101–102, 421, 423
lay treatment counselors, 317–319
legislative action to encourage, 3–4, 410–412
Medicaid programs, 361
Medicare coverage, 358–359
NCI research, 371–372
nurse training for, 315–316
obstacles to service delivery, 155
pharmacological interventions, 98–99
potential public health benefits, 28
private research initiatives, 393–395, 396
programs for underserved populations, 108–109
research needs, 435
residential treatment programs, 97–98
role of health care providers, 8, 94, 96– 97, 149, 425
self-help programs, 96
sociodemographic patterns, 57
stepped treatment, 297–298
telephone counseling programs, 97
trends, 404–405
weight gain and, 45
worksite interventions, 100–101
See also Smoking-related cancer;
Tobacco use
Smoking-related cancer
alcohol consumption and, 47, 83
bladder cancer, 47–48
colon cancer, 49–50
environmental tobacco smoke, 53–54, 413f
kidney cancer, 48
latency of intervention strategies, 39
leukemia, 52–53
oropharyngeal cancer, 46–47
pancreatic cancer, 49
potential effectiveness of preventive
intervention, 1, 30, 36, 400–401
prostate cancer, 53
stomach cancer, 50
See also Lung cancer;
Smoking cessation;
Tobacco use
Social cognitive theory, 91
Society of Thoracic Radiology, 288
Socioeconomic status
cancer burden distribution, 12, 22
cancer screening participation and, 226– 227, 230, 232, 239, 242, 243, 257
diet-related cancer risk and, 71–72, 81
interventions to improve eating habits, 147–148
lung cancer risk, 25
tobacco use, 55–57
Spiral computed tomography, 260, 276– 291, 292–293
Sputum cytology, 264, 265–271, 275, 285– 286
Stanford Five-City Study, 118, 133
Stanford Three-City Community Study, 145
Starch, dietary, 77
State government
cancer control plans, 5, 418–421
cancer prevention activities, 338–341
community-based programs, 5–6
mandated insurance coverage, 421
Medicaid programs, 359–361
monitoring of preventive services, 9
nurse licensure, 314
physical education requirements, 417
smoking cessation programs, 3–4, 101, 102, 317–319, 411
tobacco control efforts, 103–104f, 107– 108, 110–111, 407–408, 410– 412
fruit and vegetable consumption and, 67–68
whole-grain food consumption and, 75
Substance abuse as cancer risk factor, 17.
See also Alcohol consumption
Substance Abuse Prevention and Treatment Block Grant awards, 3
Sun exposure, 17
Surveillance, 156–157
government programs, 336–338
Surveillance, Epidemiology, and End Results Program, 32
Swedish Two-County Trial, 189, 194
Synar amendment, 3
Systems of health care
behavior risk reduction in, 148–153
cancer screening, 225–227, 409
delivery of behavioral interventions, 87, 88–89
determinants of screening participation, 225–227
effective delivery of prevention services, 9, 426–427
public health infrastructure, 418
public health mission, 419f
T
Taxation, 3, 39, 111, 410, 412
Telephone counseling
to improve eating habits, 145
in promoting physical fitness, 114–115
screening reminders, 245–246, 248–249
for smoking cessation, 97
weight-loss programs, 129–130
Tertiary prevention, 28
Testicular cancer screening, 161–162
Theory of Planned Behavior, 90
Theory of Reasoned Action, 90–91
Thyroid cancer, 71
Title X (Public Health Service Act), 7, 352, 423, 424
Tobacco use
characteristics of effective interventions, 407–408, 408f
geographic variation, 358
objectives of programs to reduce, 413f
pipes and cigars, 54
prevention of, 109–111
private research initiatives, 393–395, 396
recommendations for regulation of, 3–4, 410–412
research needs, 435
smokeless tobacco, 54
sociodemographic patterns, 54–57, 405
trends, 403–405
vendor licensing, 3
Tomatoes, 71
Transdisciplinary Tobacco Use Research Centers, 396
Translational Research Centers in Behavioral Science, 398
Transportation Equity Act for the 21st Century, 6
Transportation infrastructure, 6, 119, 381, 416
Transtheoretical model of change, 91–92
Treatwell study, 142
Trevose program, 129
U
Underserved populations
cancer prevention research, 374–375
cancer screening, 257
clinician skills for service delivery to, 299
health disparities research, 378–379, 382, 388
physical fitness programs, 119–120
programs to improve eating habits, 146– 148
recommendations for improving access to services, 7–8, 423–424
smoking cessation programs, 108–109
weight-loss programs to reach, 134–135
University of Alabama, 310
University of Arizona, 310
University of California, 310
University of Colorado, 310
University of Nevada, 310
University of North Carolina, 310
University of Texas, 311
V
Value expectancy theory, 89–91
Vegetables. See Fruit and vegetable consumption
Veterans Health Administration, 344–349
Vitamin A, 79
Vitamin C, 50
Vitamin D, 76
Vitamin E, 80
W
Weight-loss programs, 409
behavioral programs, 127–129
commercial, 129
community-based, 133
dietary restriction, 120–125, 136
environmental approaches, 133–134
goals, 120
maintenance of weight loss, 125–127
mediated approaches, 129–130
pharmacological treatments, 130–131
physical activity interventions, 124–127, 136–137
to reach underserved populations, 134– 135
worksite, 131–132
for young people, 135–138
Weight Watchers program, 129
Wheat, whole-grain, 74–75
Whole-grain foods, 74–75
Women’s health
oropharyngeal cancer risk, 46
screening programs, 7
underserved populations, 7
Working Well, 142
Worksite intervention
CDC programs, 383–384
fitness programs, 4
to improve eating habits, 133–134, 142– 143
insurance coverage for prevention efforts, 6–7, 422–423
promoting physical fitness, 115, 116t
screening, 247f
smoking cessation programs, 100–101
state support for, 5
weight-loss programs, 131–132