Cancer prevention: setting the scene.

Each year in the United Kingdom there are over 300 000 new cases of cancer and nearly 165 000 deaths from cancer. It is widely believed that as many as four fifths of all cancers are preventable by means that are already available. The Health of the Nation and the Europe Against Cancer Programme have set targets and strategies for reducing the risk of cancer.An approach based on the whole population will achieve the greatest reductions in morbidity and mortality. Complementary to this is the individual approach, which can be based in primary care and targeted at high risk subjects. Health promotion and screening in primary care are not in themselves self evidently valuable. Their effectiveness must be tested rigorously and scientifically.Furthermore, because of limited time and resources, health education in primary care should be focused on interventions that are likely to achieve the greatest benefit, such as helping people to stop smoking. The size of the problem Over 300 000 new cases of cancer registered in the United Kingdom each year (fig 1). On the basis of current incidence rates it is estimated that one in three people will develop cancer at some time during their life. More than 70% of all new cases occur in people aged 60 years and over. FIG 1 Numbers of new cases of cancer and deaths from cancer and five year survival rates. *Non-melanoma skin cancers1 Cancer is currently responsible for a quarter of all deaths in the United Kingdom, with nearly 165 000 deaths in 1992 (fig 1). A few cancers account for more than half of all deaths from cancer, lung cancer alone being responsible for a quarter (table I). More women die of breast cancer than any other cancer, except in Scotland and part of northern England, where deaths from lung …