The Practice of Disease Prevention

MODERN medicine has successfully learned how to prevent the most devastating of the infectious diseases. These advances were the result of the coordinated efforts of research workers and practicing physicians, as well as the willingness of the public to accept preventive measures. With this record, an obvious question is why similar results have not been achieved for today's major causes of death, particularly cardiovascular diseases, stroke, and cancer, which together account for some 70% of all deaths in the United States. Much time has passed since statistically proven risk factors for heart attacks were established by the Framingham Study, since it was demonstrated that treatment of hypertension leads to a reduction in the occurrence of strokes, since cigarette smoking was shown to be related to lung cancer and a variety of other diseases, and since Papanicolaou first demonstrated the value of cervical smears in identifying early lesions of the cervix.