Behavioral issues in prevention of cancer

Abstract

At present, the most feasible way of preventing cancer is by reducing exposure to carcinogens. Conditions and behaviors having certain, likely, and possible association with increased risk are tabulated. Psychological characteristics as potential risk factors are reviewed, but the data are inconclusive. A classification of preventive measures is presented, as well as a model of secondary prevention needs and what agents can implement them. Some principles that might affect the policy of prevention are outlined. In occupational cancer, an example of slow progress toward major preventive activity is given by reviewing the history of reducing exposure to arsenic in industry. Three interactions are examined: company medical departments and government epidemiologists; regulations proposed by government agencies and company disclosure of hazards; and experimental vs epidemiologic scientists. The role of labor unions, while small up to this time, is increasing. Finally, the increase in and association among the following are described for uranium mining: knowledge about the amount and source of hazard, government inspection, sanctions, compensation claims, press articles, hazard “visibility,” and industry safety-improvement actions. As the first group of items increases, the last one improves safety. Coercion between organizations seems to be the most potent factor in safety improvement.