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Our main approach to cancer prevention is limited, at present,
to educating the public into recognising, at an early stage, signs
and symptoms and, in the case of cervical and breast cancers, into
using the established screening clinics. In this context, exfoliative
cytology would appear to be the next logical step in the detection of
bronchial carcinoma. Some doubt has been cast upon the practica
bility of specific regular medical examinations and the fact that
these tend to reveal previously undetected disease, but, under
present circumstances, such methods must be considered to have a
place in the sphere of prevention. Greater attention needs to be
given to ensuring that people not only receive the most up-to-date
information about various cancers but also the best methods of
avoiding exposure to such hazards. Environmentally, these risks
are to be found in nutrition, foods, cosmetics, pharmaceutical
products, trauma, viruses, tobacco smoking, atmospheric pollution,
etc., many of which are obviously avoidable now, thus indicating
that man already has some control over whether he does or does
not develop certain cancers.
Knowledge concerning genetic and hormonal influences in the
generation of cancers is being constantly expanded but there may
well be difficulties in applying it in a practical preventive way.
In my 1966 Report, I summarised the current authoritative views
and hypotheses regarding the causes of cancer upon which
preventive measures must depend for their orientation and these do
not need reiteration.
However, it is interesting to record that, more recently, new
evidence has been accumulated suggesting that at least some of
the human cancers are induced by viruses. A herpes-type virus
cultivated from a Burkitt's lymphoma has induced infectious mononucleosis
in a human being with an increase in antiviral antibody
compared with normal levels. It is postulated that, although this
type of viral infection was common, resulting disease was rare;
moreover, the fact that higher than normal levels of antibody have
been found in patients with Burkitt's lymphoma, Hodgkin's disease,
lymphosarcoma, leukaemia and selected solid tumours merely
strengthens this contention and brings the prospective use of anticancer
vaccines a little nearer.
It would seem that causes of many cancers are likely to be
revealed during the next two decades and that preventive measures
will thereby become much more effective.
Childhood Cancers—Survey—During the current year cooperation
continued with Dr. Alice Stewart of the Department of
Social Medicine, Oxford University. Notifications are received of
all childhood deaths due to cancer in Greenwich during the previous