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Predictors of Successful Cancer Prevention Programs

  • Conference paper
Cancer Prevention II

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 181))

Abstract

Finding the optimal use of health-care resources requires the reliable estimation of costs and consequences. Acquiring these estimates may not be difficult for some common treatments. More difficult is the optimization of resources in the area of diagnostics. Only a few attempts have been made to optimize the use of resources in the area of prevention. Several aspects have to be considered when optimizing the resources for prevention: (1) participation rates in structured prevention programs are low, (2), acquiring data on follow-up and outcomes is difficult, (3) there are concerns about the quality of information available to public, and (4), the public is often unaware of scientific assessments of prevention programs. As prevention programs are costly long-term projects, a strategy to select these programs according to possible predictors of success might be useful. The few analyses of cancer prevention in the literature have been directed towards the most common malignant diseases (as assessed by incidence) such as cancer of the breast, colon, lung and prostate. We argue that incidence is a poor marker for selecting secondary prevention programs. Incidence may be a misleading indicator for two reasons: incidence of disease does not predict efficiency of management or good health outcomes, and incidence does not separate clinically significant from non-significant disease. The traditional strategy is based on the assumption that more screening increases the chance of cure. We propose an alternative outcomes model that suggests better disease management justifies new prevention programs. Indicators for better disease management are effective and efficient treatments as well as high-quality screening (sensitivity and specificity) techniques and possibly “side-effects of prevention programs,” which provide early signs of success to motivate the patient's participation, to keep up with the program and finally to succeed.

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References

  • Abe R, Ogawa K, Maruyama Y, Nakamura N, Abe M (2007) Spontaneous regression of diffuse large B-cell lymphoma harbouring Epstein-Barr virus: a case report and review of the literature. J Clin Exp Hematop 47:23–26

    Article  PubMed  Google Scholar 

  • Antonarakis ES, Blackford AL, Garrett-Mayer E, Eisenberger MA (2007) Survival in men with nonmetastatic prostate cancer treated with hormone therapy: a quantitative systematic review. J Clin Oncol 25:4998–5008

    Article  PubMed  CAS  Google Scholar 

  • Apitz R, Winter SF (2004) Potentials and promises of prevention—current developments in Germany. Internist 45:139–147

    Article  PubMed  CAS  Google Scholar 

  • Baker SG, Kramer BS (2007) Paradoxes in carcino-genesis: new opportunities for research directions. BMC Cancer 7:151

    Article  PubMed  CAS  Google Scholar 

  • Bang SM, Cheong JW, Yang WI, Hahn JS (2005) An unusual case of spontaneous remission of Hodgkin's disease after a single cycle of COPP-ABV chemotherapy followed by infectious complications. Yonsei Med J 46:425–430

    Article  PubMed  Google Scholar 

  • Barrat A, Howard K, Irwing L, Alkeld G, Houssami N (2005) Model of outcomes of screening mam-mography: information to support informed choices. BMJ 330:7497:936

    Article  Google Scholar 

  • Black WC, Czum JM (2007) Screening coronary CT angiography: no time soon. Vet Radiol Ultrasound 4:295–299

    Google Scholar 

  • Boyle P, Ferlay J (2005) Cancer incidence and mortality in Europe, 2004. Ann Oncol 16:481–488

    Article  PubMed  CAS  Google Scholar 

  • Brauers A, Jakse G (2000) Epidemiology and biology of human urinary bladder cancer. J Cancer Res Clin Oncol 126:575–583

    Article  PubMed  CAS  Google Scholar 

  • Bunker J P, Houghton J, Baum M (1998) Putting the risk of breast cancer in perspective. BMJ 317:1307–1309

    PubMed  CAS  Google Scholar 

  • Campbell NC (2004) Secondary prevention clinics: improving quality of life and outcome. Heart 90 [Suppl 4]:29–32

    Article  Google Scholar 

  • Dave SS (2006) Gene expression signatures and outcome prediction in mature B-cell malignancies. Curr Treat Options Oncol 7:261–269

    Article  PubMed  Google Scholar 

  • Elmore JG, Barton MB, Moceri VM, Polk S, Arena PJ, Fletcher SW (1998) Ten-Year risk of false positive screening mammograms and clinical breast examinations. N Engl J Med 338:1089–1096

    Article  PubMed  CAS  Google Scholar 

  • Gérvas Camacho J (2002) Screening for serious illness. Eur J Gen Pract 8:46–49

    Article  Google Scholar 

  • Gérvas Camacho J, Pérez Fernández M, González de Dios J (2007) Ethical and practical problems of secondary prevention. Two paediatrics examples [in Spanish]. Rev Esp Salud Publica 81:345–352

    Article  PubMed  Google Scholar 

  • Goetzsche PC, Nielsen M (2006) Screening for breast cancer with mammography. Cochrane Database Syst Rev Oct 18:CD001877

    Google Scholar 

  • Green LW, Glasgow RE (2006) Evaluating the relevance, generalization, and applicability of research. Eval Health Prof 29:126–153

    Article  PubMed  Google Scholar 

  • Güth U, Wight E, Schötzau A, Langer I, Dieterich H, Rochlitz C, Herberich L, Holzgreve W, Singer G (2006) A new approach in breast cancer with non-inflammatory skin involvement. Acta Oncol 45:576–583

    Article  PubMed  Google Scholar 

  • Hardcastle JD, Chamberlain JO, Robinson MH, Moss SM, Amar SS, Balfour TW, James PD, Mangham CM (1996) Randomised controlled trial of faecal-occult-blood screening for color-ectal cancer. Lancet 348:1472–1477

    Article  PubMed  CAS  Google Scholar 

  • Harris JR, Lippman ME, Veronesi U, Willet W (1992) Breast cancer. N Engl J Med 327:319–328

    PubMed  CAS  Google Scholar 

  • Hayes DF (1996) Serum (circulating) tumor markers for breast cancer. Recent Results Cancer Res 140:101–113

    PubMed  CAS  Google Scholar 

  • Health-EU (2003) The Public Health Portal of the European Union. http://ec.europa.eu/health-eu/ health_problems/cancer/index_en.htm. Cited 1 Jun 2008

  • Hewitson P, Glasziou P, Irwig L, Towler B, Watson E (2007) Screening for colorectal cancer using the faecal occult blood test, Hemoccult. Cochrane Database Syst Rev Jan 24:CD001216

    Google Scholar 

  • High WA, Stewart D, Wilbers CR, Cockerell CJ, Hoang M P, Fitzpatrick JE (2005) Completely regressed primary cutaneous malignant melanoma with nodal and/or visceral metastases: a report of 5 cases and assessment of the literature and diagnostic criteria. J Am Acad Dermatol 53:89–100

    Article  PubMed  Google Scholar 

  • Horino T, Takao T, Yamamoto M, Geshi T, Hashimoto K (2006) Spontaneous remission of small cell lung cancer: a case report and review in the literature. Lung Cancer 53:249–252

    Article  PubMed  Google Scholar 

  • Irvine D (2001) The changing relationship between the public and the medical profession. J R Soc Med 94:162–169

    PubMed  CAS  Google Scholar 

  • Jacobs EL, Haskell CM (1991) Clinical use of tumor markers in oncology. Curr Probl Cancer 15:299–360

    Article  PubMed  CAS  Google Scholar 

  • Jørgensen OD, Kronborg O, Fenger C (2002) A randomised study of screening for colorectal cancer using faecal occult blood testing: results after 13 Years and seven biennial screening rounds. Gut 50:29–32

    Article  PubMed  Google Scholar 

  • Kaplan RM (2006) Overdiagnosis and pseudodis-ease: too much of a “good thing”? In: Porzsolt F, Kaplan RM (eds) Optimizing health—improving the value of healthcare delivery. Springer, Berlin Heidelberg New York, pp 87–91

    Chapter  Google Scholar 

  • Kerr J, Day P, Broadstock M, Weir R, Bidwell S (2007) Systematic review of the effectiveness of population screening for colorectal cancer. N Z Med J 120:U2629

    PubMed  Google Scholar 

  • Kim DH, Pickhardt PJ, Taylor AJ, Leung WK, Winter TC, Hinshaw JL, Gopal DV, Reichelderfer M, Hsu RH, Pfau PR (2007) CT colonography versus colonoscopy for the detection of advanced neoplasia. N Engl J Med 357:1403–1412

    Article  PubMed  CAS  Google Scholar 

  • Kronborg O, Fenger C, Olsen J, Jørgensen OD, Søndergaard O (1996) Randomised study of screening for colorectal cancer with faecal-occult-blood test. Lancet 348:1467–1471

    Article  PubMed  CAS  Google Scholar 

  • Malfertheiner P, Fry LC, Mönkemüller K (2006) Can gastric cancer be prevented by Helicobacter pylori eradication? Best Pract Res Clin Gastroenterol 20:709–719

    Article  PubMed  Google Scholar 

  • Mandel JS, Bond JH, Church TR, et al (1993) Reducing mortality from colorectal cancer by screening for fecal occult blood. N Engl J Med 328:1365–1371

    Article  PubMed  CAS  Google Scholar 

  • Mandel JS, Church TR, Ederer F, Bond JH (1999) Colorectal cancer mortality: effectiveness of biennial screening for fecal occult blood. J Natl Cancer Inst 91:434–437

    Article  PubMed  CAS  Google Scholar 

  • Mandel JS, Church TR, Bond JH, Ederer F, Geisser MS, Mongin SJ, Snover DC, Schuman LM (2000) The effect of fecal occult-blood screening on the incidence of colorectal cancer. N Engl J Med 343:1603–1607

    Article  PubMed  CAS  Google Scholar 

  • Mayer O Jr, Mayer O Sr (2004) Quality of therapeutic control of hyperlipidemias in secondary prevention of coronary heart disease in the light of current recommendations [in Czeck]. Vnitr Lek 50:777–780

    Google Scholar 

  • Moayyedi P, Achkar E (2006) Does fecal occult blood testing really reduce mortality? A reanaly-sis of systematic review data. Am J Gastroenterol 101:380–384

    Article  PubMed  Google Scholar 

  • Mulhall B P, Veerappan GR, Jackson JL (2005) Meta-analysis: computed tomographic colonography. Ann Intern Med 142:635–650

    PubMed  Google Scholar 

  • Ohtani H, Yamazaki O, Matsuyama M, Horii K, Shimizu S, Oka H, Nebiki H, Kioka K, Kurai O, Kawasaki Y, Manabe T, Murata K, Matsuo R, Inoue T (2005) Spontaneous regression of hepa-tocellular carcinoma: report of a case. Surg Today 35:1081–1086

    Article  PubMed  Google Scholar 

  • Porzsolt F, Schlotz-Gorton N, Biller-Andorno N, Thim A, Meissner K, Roeckl-Wiedmann I, Herzberger B, Ziegler R, Gaus W, Pöppel E (2004) Applying evidence to support ethical decisions: is the placebo really powerless? Sci Eng Ethics 10:119–132

    Article  PubMed  Google Scholar 

  • Porzsolt F, Kilian R, Eisemann M (2007) Gefühlte Sicherheit—Ein neuer gesellschaftlicher Wert. Gesundh ökon Qual manag 12:7–10

    Google Scholar 

  • Rozenberg S, Antoine C, Carly B, Pastijn A, Liebens F (2007) Improving quality of life after breast cancer: prevention of other diseases. Climacteric 13:71–74

    Google Scholar 

  • Sackett DL (2002) The arrogance of preventive medicine. CMAJ 167:263–264

    Google Scholar 

  • Schwartz LM, Woloshin S, Fowler FJ, Welch HG (2004) Enthusiasm for cancer screening in the United States. JAMA 291:71–78

    Article  PubMed  CAS  Google Scholar 

  • Shorter E (1997) Multiple chemical sensitivity: pseudodisease in historical perspective. Scand J Work Environ Health 23[Suppl]:335–342

    Google Scholar 

  • Smith S (1992) The ethics of ignorance. J Med Ethics 18:117–118

    Article  PubMed  CAS  Google Scholar 

  • Stagmo M, Israelsson B, Brandström H, Hedbäck B, Lingfors H, Nilsson P, Erhardt L (2004) The Swedish National Programme for Quality Control of Secondary Prevention of Coronary Artery Disease—results after one Year. Eur J Cardiovasc Prev Rehabil 11:18–24

    Article  PubMed  Google Scholar 

  • Szczurko O, Cooley K, Busse JW, Seely D, Bernhardt B, Guyatt GH, Zhou Q, Mills EJ (2007) Naturopathic care for chronic low back pain: a randomized trial. PLoS ONE 2:e919

    Google Scholar 

  • Tournaire M, Theau-Yonneau A (2007) Complementary and alternative approaches to pain relief during labor. Evid Based Complement Alternat Med 4:409–417

    Article  PubMed  Google Scholar 

  • U.S. Preventive Services Task Force (2002) Screening for colorectal cancer: Recommendations and rationale. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/ 3rduspstf/colorectal/colorr.htm. Cited 1 Jun 2008

  • U.S. Preventive Services Task Force (2004a) Screening for testicular cancer: Recommendation statement. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/ clinic/3rduspstf/testicular/testiculrs.htm. Cited 1 Jun 2008

  • U.S. Preventive Services Task Force (2004b) Recommendation statement. Screening for lung cancer. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/ clinic/3rduspstf/lungcancer/lungcanrs. htm#clinical. Cited 1 Jun 2008

  • U.S. Preventive Services Task Force (2005) Genetic risk assessment and BRCA mutation testing for breast and ovarian cancer susceptibility, topic page. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/ clinic/uspstf/uspsbrgen.htm. Cited 1 Jun 2008

  • U.S. Preventive Services Task Force (2007) Guide to clinical preventive services, 2007. AHRQ Publication No. 07-05100, September 2007. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/pocketgd.htm. Cited 1 Jun 2008

  • Welch HG (2004) Should I be tested for cancer? University of California Press, Berkeley

    Google Scholar 

  • Woolf SH (2003) Pseudodisease. BMJ 327:E206

    Article  Google Scholar 

  • Zahl PH, Maehlen J (2006) Do model results suggest spontaneous regression of breast cancer? Int J Cancer 118:2647

    Article  PubMed  CAS  Google Scholar 

  • Zahl PH, Andersen JM, Maehlen J (2004) Spontaneous regression of cancerous tumours detected by mammography screening. JAMA 292:2579–2580

    Article  PubMed  CAS  Google Scholar 

  • Zentralinstitut für die kassenärztliche Versorgung in der Bundesrepublik Deutschland (2007) Wissen-schaftliche Begleitung von Früherkennungs-Koloskopien in Deutschland. Berichtszeitraum 2005-3. Jahresbericht im Auftrag der Spitzenverbände der gesetzlichen Krankenkassen und der Kassenärztlichen Bundesvereinigung. Version 1.4 (überarbeitet auf Grundlage der Beratungen im Lenkungsausschuss am 15.12.2006). Updated 20 June 2007

    Google Scholar 

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Authors and Affiliations

  1. Department of Health Services, UCLA School of Public Health, Room 31-293C CHS, PO Box 951772, Los Angeles, CA, 90025-1772, USA

    Robert M. Kaplan

  2. Clinical Economics, University of Ulm, Frauensteige 6, Ulm, 89075, Germany

    Franz Porzsolt & Anita Kirner

Authors
  1. Franz Porzsolt
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  2. Anita Kirner
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  3. Robert M. Kaplan
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Correspondence to Franz Porzsolt .

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Editors and Affiliations

  1. Zentrum fücr Tumordiagnostik und Prävention, Rorschacherstr. 150, St. Gallen, 9006, Schweiz

    Hans-Jörg Senn , Ursula Kapp  & Florian Otto ,  & 

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Porzsolt, F., Kirner, A., Kaplan, R.M. (2009). Predictors of Successful Cancer Prevention Programs. In: Senn, HJ., Kapp, U., Otto, F. (eds) Cancer Prevention II. Recent Results in Cancer Research, vol 181. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-69297-3_2

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  • DOI: https://doi.org/10.1007/978-3-540-69297-3_2

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-69296-6

  • Online ISBN: 978-3-540-69297-3

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