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National Academies Press


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Throughout history, perhaps no other disease has generated the level of social, scientific, and political discourse or has had the degree of cultural significance as cancer. A collective in the truest sense of the word, "cancer" is a clustering of different diseases that afflict individuals in different ways. Its burdens are equally broad and diverse, from the physical, financial, and psychological tolls it imposes on individuals to the costs it inflicts upon the nation's clinical care and public health systems, and despite decades of concerted efforts often referred to as the "war on cancer", those costs have only continued to grow over time. The causes and effects of cancer are complex—in part preventable and treatable, but also in part unknown, and perhaps even unknowable.

Guiding Cancer Control defines the key principles, attributes, methods, and tools needed to achieve the goal of implementing an effective national cancer control plan. This report describes the current structure of cancer control from a local to global scale, identifies necessary goals for the system, and formulates the path towards integrated disease control systems and a cancer-free future. This framework is a crucial step in establishing an effective, efficient, and accountable system for controlling cancer and other diseases.

Product Details

ISBN-13: 9780309492317
Publisher: National Academies Press
Publication date: 08/30/2019
Pages: 174
Product dimensions: 6.00(w) x 9.00(h) x 0.50(d)

Table of Contents

Summary 1

1 Complexity: From Cells to Society 11

The Scope of Cancer Control 12

Cancer Burden and Disparities 15

Difficult Trade-Offs 19

The Complexity of Cancers and Cancer Control 22

The "Continuum" of Cancer Control 24

Social Costs and Consequences 33

Complex Adaptive Systems 43

Findings 50

References 52

2 The Current "System" of Cancer Control 63

Global Efforts in Cancer Control 64

Federal Efforts in the United States 67

State and Local Initiatives 72

Performance Evaluation 75

A Vigorous System of Participants and Interests 77

Consumer and Other Technology Firms in Cancer Control 79

Historically Common Themes 84

Public Trust in Cancer Control 87

Toward a Consolidated Vision 89

Findings 90

References 93

3 Guiding the System of Cancer Control 101

Systems Engineering in Society 102

Systems Approaches in Cancer Control 105

Systems Analyses and Systematic Trade-Offs 110

Building a Multi-Level Model 117

Guidance Systems for Cancer Control 121

Findings 124

References 125

4 A Path to Transformation 127

Conclusions 128

Recommendations 131

Applying the Guidance System 135

From Many to One: Advancing the Practice 137

Building New Capabilities and Competencies 142

Working for Success 143

Setting a Precedent 145


A Stakeholder Input 147

B Biographical Information 149

C Disclosure of Unavoidable Conflict of Interest 159

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