American Cancer Society/ American Urological Association International Workshop on Prostatic Cancer and Hyperplasia. Sea Island, Georgia, October 26-29, 1991.
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Collectively, cardiovascular disease (including stroke), cancer, and diabetes account for approximately two thirds of all deaths in the United States and about 700 billion dollars in direct and indirect economic costs each year. Current approaches to health promotion and prevention of cardiovascular disease, cancer, and diabetes do not approach the potential of the existing state of knowledge. A concerted effort to increase application of public health and clinical interventions of known efficacy to reduce prevalence of tobacco use, poor diet, and insufficient physical activity-the major risk factors for these diseases-and to increase utilization of screening tests for their early detection could substantially reduce the human and economic cost of these diseases. In this article, the ACS, ADA, and AHA review strategies for the prevention and early detection of cancer, cardiovascular disease, and diabetes, as the beginning of a new collaboration among the three organizations. The goal of this joint venture is to stimulate substantial improvements in primary prevention and early detection through collaboration between key organizations, greater public awareness about healthy lifestyles, legislative action that results in more funding for and access to primary prevention programs and research, and reconsideration of the concept of the periodic medical checkup as an effective platform for prevention, early detection, and treatment.
Over the past year, the National Cancer Institute has altered its guidelines for early breast cancer screening by omitting any recommendation for mammography and clinical breast examination for women aged 40 to 49 years, while the American Cancer Society has reaffirmed its recommendation for these screening procedures in this age group. This article reviews the process and some of the evidence the American Cancer Society has relied upon in reaffirming its recommended guidelines for early breast cancer detection.
Collectively, cardiovascular disease (including stroke), cancer, and diabetes account for approximately two-thirds of all deaths in the U.S. and about US dollars 700 billion in direct and indirect economic costs each year. Current approaches to health promotion and prevention of cardiovascular disease, cancer, and diabetes do not approach the potential of the existing state of knowledge. A concerted effort to increase application of public health and clinical interventions of known efficacy to reduce prevalence of tobacco use, poor diet, and insufficient physical activity-the major risk factors for these diseases-and to increase utilization of screening tests for their early detection could substantially reduce the human and economic cost of these diseases. In this article, the American Cancer Society, American Diabetes Association, and American Heart Association review strategies for the prevention and early detection of cancer, cardiovascular disease, and diabetes, as the beginning of a new collaboration among the three organizations. The goal of this joint venture is to stimulate substantial improvements in primary prevention and early detection through collaboration between key organizations, greater public awareness about healthy lifestyles, legislative action that results in more funding for and access to primary prevention programs and research, and reconsideration of the concept of the periodic medical checkup as an effective platform for prevention, early detection, and treatment.
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We compared the effectiveness of American Cancer Society, FreshStart, American Lung Association, Freedom from Smoking, and laboratory clinic methods in subjects (N = 1041) from three communities. Three-month follow-up results favored the laboratory method over the two public service approaches on both a prevalence and a sustained abstinence measure. At one-year follow-up, treatment effects for smoking prevalence were no longer significant. However, sustained abstinence results at one-year remained highly significant and favored the more intensive laboratory and Freedom from Smoking clinics over the FreshStart method. FreshStart fared less well than the other interventions both in producing initial quit attempts and in sustaining abstinence among initial quitters. It should be noted, however, that FreshStart requires considerably less facilitator contact than do the other approaches. Unexpected outcome effects occurred for treatment location. Future clinic programs should include a specific target date for quitting and should place more emphasis upon recycling participants who fail to sustain abstinence.
The American Cancer Society is the major organization that provides cancer education to health professionals in the United States. This is implemented not only by the National Office but through 58 Divisions and over 3000 local Units. Objectives for professional education emphasize informing physicians and the multiple disciplines of health professionals engaged in primary care about cancer detection and prevention, particularly for breast, lung, colon, rectal, and cervical cancers. A plan is now being developed for a professional education program to the year 2000. Cancer control programs sponsored or planned by the Society include the Colorectal Health CHECK program, Smoke Free Young America, Breast Cancer Detection Awareness, and Cancer Risk Reduction. These programs demonstrate an effective partnership between professionals and lay volunteers. The Society also offers Clinical Fellowships, Medical and Nursing Professorships, and Nursing Scholarships to further professional education. National conferences are sponsored by the Society, as are special graduate courses for physicians from foreign countries. In addition, numerous publications and audiovisuals are available through Units to supplement professional, as well as lay, education.
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Cancer survivors are often highly motivated to seek information about food choices, physical activity, and dietary supplement use to improve their treatment outcomes, quality of life, and survival. To address these concerns, the American Cancer Society (ACS) convened a group of experts in nutrition, physical activity, and cancer to evaluate the scientific evidence and best clinical practices related to optimal nutrition and physical activity after the diagnosis of cancer. This report summarizes their findings and is intended to present health care providers with the best possible information from which to help cancer survivors and their families make informed choices related to nutrition and physical activity. The report discusses nutrition and physical activity issues during the phases of cancer treatment and recovery, living after recovery from treatment, and living with advanced cancer; select nutrition and physical activity issues such as body weight, food choices, and food safety; issues related to select cancer sites; and common questions about diet, physical activity, and cancer survivorship.
The American Cancer Society (ACS) Nationwide Asian-American/Pacific Islander (AAPI) Initiative is a continuing collaboration between the ACS and other organizations and community groups. With a view to incorporating access to quality treatment as an over-arching principal, the objectives of the AAPI Initiative are to provide strategic oversight to the ACS for outreach to AAPI populations and to develop a nationwide plan for the purpose of making ACS programs and services available to these populations. After a series of meetings in 2002, including a joint meeting between the Asian American Network for Cancer Awareness, Research, and Training (AANCART) and the ACS, the first ACS Nationwide AAPI Council meeting was held in early 2003. The goals and objectives of this initiative are 1) to develop a plan for delivery of ACS programs and services to the AAPI population, 2) to develop a program for collaboration with organizations that can help the ACS reach its objectives, 3) to develop an advocacy program that enables the ACS to reach its objectives, and 4) to develop an income-development program to both reach and maintain these objectives. The ACS-AANCART collaboration is a great example of the type of collaboration that will make not only the ACS but also the cancer community as a whole successful in eradicating cancer as a major public health problem.
The American Cancer Society (ACS) Study of the effects of long-term exposure to ambient air pollution on mortality used metropolitan areas to assign exposures to individual cohort members (Pope et al., 1995); these authors did not, however, control for any other place-specific variables in their analysis. Consequently, the study has been criticized on the basis that the association observed between air pollution and mortality may be confounded by other unmeasured ecologic covariates. To address this criticism, the reanalysis team selected a set of place-specific variables that measured determinants of health ranging from the biophysical environment to the social environment and the healthcare system. This article outlines the process by which place-specific ecologic covariates were selected; data measuring these variables were obtained and geographic boundaries for places were delineated. Issues involved in obtaining and using geographically based ecological data are examined within the context of the reanalysis of the ACS study. Both the ecological fallacy and the atomistic fallacy are addressed and an argument is made for the importance of studying the effects of place-specific variables that are integral or contextual in nature. Issues relating to the Modifiable Areal Unit Problem (MAUP) are explored with reference to using ZIP codes and data from a variety of sources. It is argued that differences in the geographical scale of variability for various pollutants may prove to be the key to distinguishing between their relative impacts on health and that multilevel analyses are essential for understanding the impact of social and environmental determinants of health. A number of determinants of health are then briefly examined in terms of their association with mortality, the appropriateness of their being measured at the metropolitan scale, and the availability of data for the 1980s from U.S. sources. Finally, the article presents the database of place-specific ecologic covariates that was incorporated into the ACS models during the reanalysis in order to account for the influence that place may have above and beyond ambient air pollution.
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BACKGROUND: American Joint Committee on Cancer (AJCC) staging is increasingly accepted as a prognostic standard for cancer management. The Commission on Cancer requires approved cancer programs to use AJCC staging for all cancers. Previous studies document increasing use of AJCC staging by hospitals with cancer programs. This review examines programmatic and clinical factors affecting AJCC staging completeness. METHODS: The data are registry records submitted to the National Cancer Data Base (NCDB) for cases diagnosed during 1993 or, for comparison, 1988. RESULTS: The mean facility staging rate was 87% in 1993, up from 65% in 1988. Approximately 64% of facilities staged greater than 90% of their stageable cases; 3% staged less than 5%. Even facilities with "complete" staging implementation were unable to stage substantial portions of some sites. Accessibility of tumor and overall prognosis affected the choice between pathologic and clinical staging. Staging completeness and the mix of pathologic and clinical staging also differed by state of the reporting facility. CONCLUSIONS: AJCC staging use is high among common tumors for which treatment is dependent upon stage of disease. However, if accurate staging is not expected to affect the treatment or outcome of the case or the overall outcome is poor, staging is less frequently recorded.
American Cancer Society (ACS) literature commonly used to inform patients about cancer-detection methods, life-style risks, and treatment modalities was examined for readability. Fifty-one booklets obtained from a regional ACS office were evaluated. According to the SMOG formula, the reading level estimates of the booklets ranged from grade 5.8-15.6 (SD = 2.2), with a mean reading level of grade 11.9. The sampled cancer materials may be too difficult for many Americans to read and understand since most of the booklets (55%) were written for individuals with grade 12 or higher reading skills. Only one booklet was written at less than a grade six reading level. Booklets produced since 1985 were written at significantly lower reading levels (p less than 0.05) than those published in earlier years. The nurse's role in cancer education encompasses awareness of patients' diverse reading skills and formulation of a systematic method to develop materials that meet the needs of low-literacy groups.
In 1984, the American Cancer Society (ACS) determined that a substantial proportion of new cancer cases could be avoided if seven dietary guidelines were followed. Education programs were developed for the general public, young people, and the mass media. In 1989, a Working Group of the Society reviewed the guidelines and found them to be valid, the only change being to combine two of them. This paper summarizes recent dietary recommendations of other health authorities, describes progress in meeting ACS dietary recommendations, analyzes the barriers to and opportunities for dietary improvement, and proposes new leadership opportunities for the Society. Concern is expressed that the current guidelines lack the clarity and specificity needed for public education, and that they are inconsistent with recent dietary recommendations of other authorities such as the US Department of Health and Human Services and the National Academy of Sciences. Revisions to the ACS Dietary Recommendations and implications for ACS programs are proposed.