If a person is at increased risk for developing a certain
type or types of cancer, he or she should consult with his
or her health care practitioner to tailor risk-reducing
measures to his or her personal needs. Some people may
be able to reduce their risk by modifying their behaviors,
for example, by quitting smoking. Others might need to
increase their use of certain cancer screening tests or use
cancer screening tests that are not recommended for people
who are generally healthy. Yet others may consider taking a
preventive medicine or having risk-reducing surgery (see
Table 5 and Supplemental Table 1, p. 108).
Recent data show that about 10 percent of childhood
cancers are associated with specific, inherited genetic
mutations. In an effort to facilitate early detection and
treatment of these cancers, the AACR convened an
international group of leading pediatric cancer experts
who have developed and published consensus screening
surveillance recommendations for children with the most
common cancer predisposition syndromes ( 97).
As we learn more about the genetic, molecular, and cellular
characteristics of precancerous lesions and the biology
of cancer, we will be able to develop and implement new
strategies that pair this increased understanding with
knowledge of an individual’s unique cancer risk profile,
including his or her genetic makeup at birth, exposures
to cancer risk factors, age, and gender. This information
will allow us to better tailor cancer prevention and early
detection to the individual patient, ushering in a new era of
precision cancer prevention ( 98, 99). Importantly, we must
ensure that advances are uniform for all segments of the
population, which may prove challenging given that there
are currently significant disparities in cancer screening
rates among certain segments of the U.S. population (see
sidebar on Disparities in Cancer Screening).
APC Colon cancer Colectomy Colon/large intestine
BRCA1 or BRCA2 Breast and Mastectomy and Breasts, and
ovarian cancers salpingo-oophorectomy ovaries and fallopian tubes
CDH1 Stomach cancer Gastrectomy Stomach
Mutations associated Colon, endometrial, Colectomy, hysterectomy, Colon/large intestine,
with Lynch syndrome and ovarian cancers and salpingo-oophorectomy uterus, and ovaries
and fallopian tubes
RET Medullary thyroid cancer Thyroidectomy Thyroid
Genetic Mutation Cancer Technique Removes
Surgeries for the Prevention of Cancer Table 5
Whites are 32
percent more likely
to be up to date
with colorectal cancer screening than
American Indians/Alaska Natives.
Women in the
bracket are 19
percent more likely to be up to date
with cervical cancer screening than
women in the lowest income bracket.
Women who have
private health insurance
are more than twice as
likely to be up to date with breast cancer
screening than women who are uninsured.
varies by U.S. state,
with those in Massachusetts 31 percent
more likely to be up to date with
screening than those in Wyoming.
are 12 percent
more likely to
be up to date with cervical cancer
screening than gay women.
Disparities in Cancer Screening
women in the U. S.
are twice as likely
to have never had a mammogram
than U.S.-born women.
There are disparities in adherence to United States Preventive Services Task Force (USPSTF)
cancer screening recommendations among certain segments of the U.S. population ( 100, 101).
These disparities, which highlight the need for new public policies to increase cancer screening
uptake among disadvantaged segments of the U.S. population, include the following:
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