A productive history and physical examination in the prevention and early detection of cancer

Family physicians must continually deal with the problem of an adequate evaluation of presymptomatic conditions on periodic health examinations. The medicoscientific community has produced little evidence that most traditional screening has improved morbidity and mortality statistics. Listening to the patient in a concerned, humanistic manner and thoroughly examining them will detect most cancer as well as its precursors. Enough must be known about risk factors, pathophysiology, and available therapy to be able to recommend the most efficient and productive plan for continued monitoring or for further work-up where indicated. Health screening techniques may be performed by nonphysicians, but they must supplement not replace the doctor-patient relationship if compliance is to be expected.