Control of colorectal cancer
Prospects for preventing
death from colorectal cancer are now more promising than even 10 years
ago. To achieve this goal public health decisions have to be taken, and
part of this decision process involves deciding at which point enough
epidemiological evidence
is available to change focus comfortably from information generation to
health actions.
To turn research findings
into public health strategies for controlling the incidence of and mortality
from colorectal
cancer requires a profound
change of mentality in the epidemiological community. It is easy to say
that more studies
are needed, but they would
be unlikely to alter existing conclusions. Moreover, the implementation
of strategies to
control cancer must be considered
separately from research into the control of cancer.
One consequence of epidemiological
research into the contribution of lifestyle factors to cancer risk has
been to blame the individual who develops cancer. Smoking, alcohol, dietary
imprudence, and exposure to sunlight tend to assign responsibility to the
individual. The individual is often not principally responsible for decisions
about factors that influence his or her risk of cancer, and society—including
government and industry—could do more to discourage lifestyles associated
with cancer risk. Government
legislation, including taxation policy and other actions, could have profound
effects on
smoking habits, for example.
The goal of all cancer research
and treatment is to prevent people dying from the disease. Knowledge has
been accruing
rapidly about actions and
interventions that could lead to a reduction in death from colorectal cancer
by reducing the risk
of developing the disease,
identifying the disease at a stage when it is more curable, or improving
the outcome of
treatment.
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