Textbook of Cancer Epidemiology


H-O Adami et al (eds)
Published by Oxford University Press (2002)
ISBN: 0-1951-0969-4. 575 pages plus index.
RRP: A$195.00


This is a new textbook, edited by Hans-Olov Adami, David Hunter and Dimitrios Trichopoulos, with contributions from 24 experts from Europe, North America and Australia. Highly regarded textbooks already exist on cancer epidemiology, but this one makes a useful additional contribution. Its strength lies in the integration of subject matter from classic epidemiological research, genetic and molecular epidemiology and, to a lesser extent, clinical medicine.

There are two main sections. The first deals with basic epidemiological concepts, the global burden of cancer, epidemiological measures, approaches for revealing genetic determinants of cancer risk, and the integration of biomarkers in the epidemiological process.

The second part addresses cancer sites sequentially, using a standard structure that covers key clinical characteristics, descriptive epidemiological features, genetic and molecular characteristics and risk factors. Integrated summaries are provided. The glossaries are useful, where provided, especially in the chapters on genetic epidemiology and concepts in cancer epidemiology and aetiology.

The editors highlight the importance of primary prevention as potentially the most effective and efficient way forward in cancer control. They indicate that most cancers vary in incidence at least five-fold around the world. A large contribution from environmental factors to this variation can be assumed from the tendency for incidence among migrants to converge over time on incidence rates for their new home countries.

The successes of epidemiology in disclosing cancer causes over the past 50 years are described, particularly in relation to lung, breast, stomach, large-bowel, liver, cervical, endometrial and skin cancers. The authors believe that the pace of epidemiological discovery is not diminishing and that there is cause for optimism that momentum will be maintained, largely because of:

  • advances in epidemiological and statistical methodology; 
  • increased use of large cohort studies to cover many of the less common and under-researched cancers; 
  • improved methods of exposure assessment; 
  • more reliable and sophisticated laboratory measures of biomarkers as proxy endpoints; 
  • sequencing of the human genome and rapid development of means of defining inherited susceptibilities; and
  • improved methods for sub-categorising cancers with potentially different aetiologies for independent study.

The importance of research collaboration between epidemiologists, biologists and clinicians is advocated as a central theme, so that advantage can be taken of opportunities to unravel the contributions of genetic, lifestyle and environmental factors in cancer causation.

The book is written for students of epidemiology, public health, medicine, biology, and the behavioural sciences. An in-depth understanding of epidemiological theory, research design, statistics and causal reasoning is not required, nor is there a need for expertise in medicine, oncology or biology. Experts also will find the contents useful as a means of taking stock of research developments across the breadth of epidemiology and related fields.

I recommend this text as a worthy bookshelf addition, both for the experienced epidemiologist and student.

D Roder
The Cancer Council South Australia
Eastwood, SA

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