In the control of cancer, early detection and correct diagnosis rightfully demand the utmost in terms of effort, imagination, and competency. The attitude of the physician is the most important single element necessary to assure recognition of malignant disease in the earliest stages. Since the family physician usually sees the patient first, he is in a unique position to undertake simple procedures which can yield so much in establishing the presence or absence of cancer. Obviously he must have a high index of suspicion and a heightened awareness of the possibility of the complex of cancer.

No cure for systemic cancer has been found despite striking advances in medical performance and knowledge. It is possible that for many years to come we shall have to learn to use even more effectively those tools now available and meanwhile to continue the search for new knowledge of the causation and precise nature of the malignant process. With or without the means to cure malignant disease, it is possible to see with increasing clarity the necessity for recognizing cancer in its earliest stages to assure the most effective use of the treatment procedures now available.

Although no cure for systemic cancer has been discovered, it has nevertheless been possible to make significant advances in saving the lives of patients in whom cancer is detected. One hundred years ago a patient with cancer had little chance of survival. Ten or twenty years ago a cancer patient had perhaps one chance in four of recovery. Today, fairly accurate statistics suggest that a patient with frank cancer has one chance in three of getting well. Much of this progress, to be sure, has been due to technical improvements in the treatment of cancers by surgical procedures and by radiation therapy. But surely some of this gain is due to improvements in examination procedures that enable the early detection of cancer or precancerous lesions at a time when the cancers are sufficiently localized to be amenable to standard therapy.

It has been authoritatively estimated that today approximately half of all cancer patients could be cured if their lesions were detected as early as is now possible, with regular examinations and the best examining techniques, and if they were treated with all of the best resources of modern medicine and surgery.

Advances on several fronts will need to be made to close this gap between one-third of cancer patients cured today and a potential cure rate of 50%. But it is manifest that one important step toward improving the cancer cure rate is wide application of cancer detection procedures to asymptomatic patients plus application of the best available diagnostic procedures combined with skill and insight in interpretation of the findings. Also needed is constant attention to improvement of cancer detection procedures as well as possible development of new ones.

It is clearly the responsibility of leaders in the fight against cancer to provide simple, concise, and authoritative guidelines to the practitioner and others engaged in cancer control. Dr. ODonnell, Dr. Day, and Dr. Venet have provided one such template in this book. The preface sets forth cogently the parameters involved in the authors' decision to bring forth this monograph drawn from their extensive experiences. The chapters are arranged in an orderly sequence, with the major anatomic sites of cancer discussed in semioutline fashion. Directions, procedures, and explanations are simple but explicit, and the illustrations and drawings are excellent. Physicians who use this book faithfully can hardly fail to detect cancer in the critically important early stages.