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By Tai Chi Yang

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Prevention of occupationally induced cancers involves minimizing exposure to carcinogenic substances such as asbestos, ionizing radiation, and benzene compounds. Chemoprevention has been widely studied for primary cancer prevention (see above Chemoprevention section and Chapter 39). Use of tamoxifen, raloxifene, and aromatase inhibitors for breast cancer prevention is discussed in Chapters 17 and 39. Hepatitis B vaccination can prevent hepatocellular carcinoma (HCC), and screening and vaccination programs may be cost-effective and useful in preventing HCC in high-risk groups such as Asians and Pacific Islanders.

Clinical breast examination Every 3 years age 20–40 and annually thereafter. Good evidence for annual screening women aged 50– 69 by clinical examination and mammography. Insufficient evidence to recommend for or against. Mammography Annually age 40 and older. Current evidence does not support the recommendation that screening mammography be included in or excluded from the periodic health examination of women aged 40–49. Recommended every 1–2 years for women aged 40 and over (B). Papanicolaou test Annually beginning within 3 years after first vaginal intercourse or no later than age 21.

2005 Jun;66(6):346–8. [PMID: 15974163] Houry D et al. Does screening in the emergency department hurt or help victims of intimate partner violence? Ann Emerg Med. 2008 Apr;51(4):433–42. [PMID: 18313800] Jackson RD et al; Women’s Health Initiative Investigators. Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med. 2006 Feb 16;354(7):669–83. [PMID: 16481635] Koroukian SM et al. Analysis of injury- and violence-related fatalities in the Ohio Medicaid population: identifying opportunities for prevention.

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