Prevention and Early Detection of Cancer in the United States

Cancer is a major public health problem in the United States. Many types of cancer may be prevented by adopting a healthy lifestyle and avoiding mutagens and carcinogens, such as tobacco. Primary cancer prevention refers to the prevention of cancer through health promotion and risk reduction. This includes carcinogen avoidance, use of cancer vaccines or chemoprevention agents, and consideration of prophylactic surgeries in individuals at high risk for developing cancer, such as those with genetic predispositions (Jennings-Dozier & Mahon, 2002; Meyskens & Tully, 2005).

Cancer screening and early detection are forms of secondary cancer prevention aimed at detecting cancer early, when it is most treatable. Tertiary cancer prevention refers to the prevention and early detection of second primary cancers in individuals who have been diagnosed with cancer. This includes the application of specific tests to detect cancer and the use of chemoprevention agents to prevent the development of additional cancers (Champion & Rawl, 2005; Jennings-Dozier & Mahon, 2002; Smith, Tully, & Padberg, 2005; Smith, Cokkinides, & Eyre, 2006).

It Is the Position of ONS That

Cancer Prevention and Detection Services

• Oncology nurses develop, implement, and evaluate measures to ensure that individuals and families have access to education about cancer prevention
  and appropriate cancer screening.
• Advanced practice oncology nurses obtain, document, and interpret cancer risk assessments; recommend appropriate cancer early-detection and prevention strategies to individuals and families; and arrange or provide comprehensive cancer screening services based on the individual’s level of risk.
• Cancer survivors receive age-appropriate cancer screening for new cancers.
• Programs that focus on early detection of specific cancers (e.g., breast, prostate) also contain content on prevention and detection of other common cancers.
• Individuals are assessed for eligibility for chemoprevention trials based on personal level of risk, informed about the trials, and offered participation in the trials if eligible.
• Individuals are fully informed of their options for managing their personal risks for developing cancer and understand the limitations, benefits, and risks of each strategy.

Public Education

• Oncology nurses are well suited to provide education to the general public about prevention measures and general population screening guidelines for the early detection of cancer.
• Oncology nurses also are well suited to provide the necessary information and education to facilitate client decision making about participation in cancer prevention and control clinical trials.
• Oncology nurses strive to provide comprehensive cancer prevention education and early-detection services in a manner consistent with the cultural background and healthcare beliefs of individuals and families. Educational materials are targeted to the appropriate level of literacy and are culturally sensitive.
• Oncology nurses are involved in the development of educational resources that have a focus on wellness, including the prevention and early detection of cancer in at-risk populations.
• Education programs are developed and provided on the primary prevention of cancer (e.g., smoking cessation programs, nutritional counseling, cancer vaccines, avoidance of exposure to ultraviolet light) beginning in childhood and throughout life to encourage people to adopt healthy lifestyles (Mahon, 2003).

Professional Education

• Oncology nurses, at both the generalist and advanced practice levels, must have educational preparation in behavioral, biologic, educational, and economic principles of cancer prevention and early detection.
• Continuing education and specialized educational programs must be developed and provided to practicing nurses to facilitate integration of cancer prevention and early detection into clinical practice.
• Oncology specialty certification examinations and nursing licensure examinations should include evaluation of knowledge related to cancer prevention and detection practices in the general population.

Research

• Oncology nurses conduct research to further assess the efficacy of cancer prevention and early-detection programs, the psychological impact of cancer prevention and detection strategies, and promotion of participation in prevention and early-detection activities.
• Research related to cancer prevention and detection strategies is integrated into practice.

Health Policy

• The development and evaluation of cancer prevention and detection health policy are based on cancer control research and use a multidisciplinary approach that includes the public.
• Payers provide coverage for cancer risk assessment counseling, cancer predisposition genetic testing, smoking cessation aids or programs, cancer vaccines,and early-detection and screening services based on individual risk.
• Payers provide coverage for clinical trials evaluating cancer prevention and detection strategies and chemoprevention.

References

Champion, V.L., & Rawl, S.M. (2005). Secondary prevention of cancer. Seminars in Oncology Nursing, 21, 252–259.

Jennings-Dozier, K., & Mahon, S. (Eds.). (2002). Cancer prevention, detection, and control: A nursing perspective. Pittsburgh, PA: Oncology
Nursing Society.

Mahon, S.M. (2003). Patient education regarding cancer screening guidelines. Clinical Journal of Oncology Nursing, 7, 581–584.

Meyskens, F.L., & Tully, P. (2005). Principles of cancer prevention. Seminars in Oncology Nursing, 21, 229–235.

Smith, J.J., Tully, P., & Padberg, R.M. (2005). Chemoprevention: A primary cancer prevention strategy. Seminars in Oncology Nursing, 21, 243–251.

Smith, R.A., Cokkinides, V., & Eyre, H.J. (2006). American Cancer Society guidelines for the early detection of cancer, 2006. CA: A Cancer Journal for Clinicians, 56, 11–25.

Approved by the ONS Board of Directors, 4/01; revised 8/02, 10/04, 3/05, 3/07.