Letter from the Editors

Issue 25 Summer/Fall 2015

Over the past 100 years, the rise of chronic diseases, notably cancer and cardiovascular disease, has sparked a continuing interest in prevention and early detection. About a century ago, around the time of the First World War, the annual check-up began its rise to prominence as a major tool in preventive care. And it was in 1913 that the American Cancer Society was founded, chief among its goals being the development and encouragement of the means for early detection of cancer.

A century has gone by, and in that time cancer screening has become one of the most contentious areas in medicine. Nonetheless, most can agree that, in the US, great gains have been made in screening for cervical cancer, with an 85% drop in the incidence of the disease; colorectal cancer, where incidence rates have fallen by 25% and are continuing to fall; and in breast cancer, where improvements in breast cancer mortality have occurred.

Nonetheless, arguably the most important cancer has been lung cancer, which is by far the largest cause of cancer-related mortality in the United States and in the world. Of course, the main strategy used in the fight against this disease has been tobacco cessation and control. At least in the US, this strategy has been highly successful and lung cancer incidence and mortality rates are falling.

Lung cancer screening was always a gleam in the eye. Great efforts were made in the 1960s and 1970s to investigate the use of chest x-rays for screening but they proved to be too insensitive for that purpose; a recent large trial confirmed that fact. However the development of chest CT scans raised their use as a screening tool and hence a large randomized trial was conducted that recently reported a 20% reduction in mortality for smokers who were screened with this tool. As we report in this issue of Cancer Prevention, Medicare recently announced that it would reimburse for screening with CT scans.

Thus, the cancer prevention community is standing at the beginning of a new era. We will stand by to see how this affects behavior in primary care offices, among patients, and in the broader prevention community.

The Editors:

Andrew J. Dannenberg, MD
Henry R. Erle, MD-Roberts Family Professor of Medicine
Weill Cornell Medical College
Co-Director, Cancer Prevention Program
NewYork-Presbyterian Cancer Centers

Alfred I. Neugut, MD, PhD
Myron M. Studner Professor of Cancer Research
Professor of Medicine an0Epidemiology
Associate Director for Population Sciences
Herbert Irving Comprehensive Cancer Center
Columbia University College of Physicians and Surgeons
and Mailman School of Public Health
Co-Director, Cancer Prevention Program
NewYork-Presbyterian Cancer Centers