The ESMO Handbook of Cancer Prevention, from the European Society for Medical Oncology, contains state-of-the-art, practical guidance on reducing cancer risk, screening for tumors and preventing their spread. "Every year, more than 10 million people around the world develop cancer," says Professor David Kerr, ESMO President-Elect. "The reality is that many of those cases could be prevented--whether by giving up smoking, changing diet, avoiding infectious diseases or by national screening programs." In order to increase awareness, ESMO's handbook of 22 chapters brings together vital information on preventing a range of cancers, including those that affect the lungs, cervix, breast, prostate and colon. Chapters devoted to tobacco, alcohol, nutrition, workplace risks and hereditary cancer provide recommendations on the best ways to reduce cancer risk. "ESMO believes that time has come for cancer prevention to be given the highest possible priority, and we hope this handbook will serve as a practical tool in that effort," says Professor Hans-Joerg Senn, Chair of the ESMO Cancer Prevention Working Group. "In the near future medical oncologists will play a greater role in different aspects of cancer prevention, especially in chemo- and bio-prevention of important tumors such as breast cancer," Prof. Senn adds. "And as new technologies such as anticancer vaccines become available, that role will become increasingly important." The handbook is part of a wider commitment from ESMO to promote the importance of cancer prevention. This week, ESMO Past-President Professor Hakan Mellstedt will give an invited presentation at an event in Brussels organized by the group 'Members of the European Parliament Against Cancer' (MAC) in collaboration with The Parliament Magazine. "ESMO is extremely pleased to support MEPs Against Cancer in their campaign for improved cancer screening in Europe," said Professor Mellstedt. "It is clear to us that by failing to make it a priority, EU Member States are currently missing important opportunities to reduce the burden of cancer among their citizens."

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In the 1990s, according to the study, uncontrolled hypertension for women increased the most in Idaho and Oregon (up 6 percentage points) and the least in Washington, D.C., and Mississippi (down 3 percentage points). For men, the worst-performing (smallest decline) states were New Mexico and Louisiana and the best-performing states were Vermont and Indiana.

The variation in increases should be interpreted with caution, Ezzati said. We can't tell from our study why this is happening. It could be that the states have done a better job in their public health efforts to reduce hypertension or it could be that rates are already so high that they didn't have much higher to go.

Researchers determined that between 2001 and 2003, deaths attributed to the higher than optimal systolic blood pressure control among females ranged from 200 to 220 per 100,000 in Minnesota and Massachusetts to 360 to 370 in Washington, D.C., and Mississippi. For males, deaths from high blood pressure were 210 per 100,000 in Colorado and Utah to 370 in Mississippi and 410 in Washington, D.C.

It is alarming that U.S. states are experiencing worsening rates for a risk factor that is so easily controlled by lifestyle, diet and medication, Ezzati said. We need to look nationally, but also especially focus on those states with the highest hypertension prevalence and emphasize interventions to do better than last decade's trends.

High blood pressure is the most commonly occurring preventable risk factor for heart disease and stroke, said Dan Jones, M.D., President of the American Heart Association. Easily applied methods for prevention and treatment are available. It is amazing that blood pressure control rates are not improving in our country. Public health officials, policy makers, health professionals, and the American public need to respond. With more exercise, better diets, and appropriate use of antihypertensive medications, this disturbing trend in low control rates can be resolved.

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