Primary Prevention

The capabilities for preventing disease and premature death due to smoking-related cancers are far from exhausted. If we apply the percentages stated in the individual sections on smoking-related cancers to the number of deaths that occur annually in Germany, we find that approximately 36 000-46 000 deaths (i.e., 17-22%) are attributable to smoking alone and thus can be classified as preventable cancer deaths (see table below). This means that of the some 210 000 cancer deaths that occur in Germany each year, as many as 36 000-46 000 could have been prevented, and can be prevented in the future, by the cessation of smoking.

Table: Cancer deaths in Germany (1995) that could be prevented by the cessation of smoking

Cancer deaths in Germany (1995) that could be prevented by the cessation of smoking

Graph as pdf-file

In the area of nutrition as well, it is known that certain dietary changes can contribute significantly to the prevention of cancer. Although quantitative data on the situation in Germany were unavailable at the time this atlas was published, it should be noted that even a moderate reduction of the diet-associated risk (e.g., by a realistic 5-10%) would, in the short term, prevent 10 000-20 000 cancer deaths annually.

Effort to prevent exposure to carcinogens at the workplace must be continued. Also, it should be determined whether safety measures adopted by many industries in the 1960s and 1970s have actually been effective in reducing occupation-associated cancer mortality.

Measures to reduce environmental air pollution must be continued, with particular emphasis placed upon vehicular emissions. The hazard posed by diesel soot should be investigated, and planned emission guidelines should be revised as necessary.

The potential value of vaccinations in reducing the risk of virus-associated cancers (papillomaviruses and cervical cancer, hepatitis viruses and liver cancer) should be studied further.

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