A clinical cancer prevention curriculum in a comprehensive cancer center

Interns, residents, and medical students who spend one month at a comprehensive cancer center are presented with a strategy to incorporate cancer preventive services into their outpatient practices. This is accomplished through didactic lectures in clinical epidemiology. Terms that are essential to an understanding of disease occurrence are defined including incidence, prevalence, and mortality rate. Odds and probability are explored with the introduction of the odds ratio and the identification of risk factors. Primary and secondary cancer prevention are defined, and parameters related to cancer screening are introduced (sensitivity, specificity, prevalence, and positive predictive value). Risk factors for malignancy are identified where they are known and can be modified. Primary prevention strategies are reviewed by site along with data that support or refute recommendations for site-specific screening. Medical conditions and risk factor profiles that define high-risk groups are reviewed. Trainees are given copies of the US Preventive Services Task Force screening recommendations and a clinical handbook. The impact of this information on clinical practice patterns remains to be evaluated.