Cancer Control Continuum

The cancer control continuum has been used since at least the mid-1970s to describe the various stages from cancer etiology, prevention, early detection, diagnosis, treatment, survivorship, and end of life.

Like many other useful concepts, the continuum is oversimplified. As modern biology has changed our understanding of cancer, we now recognize that the categories are useful labels, but the processes are not so discrete. For example, we recognize that colonoscopy is both a screening test for colon cancer and a prevention strategy if polyps are found. Moreover, some research topics are crosscutting. For example, epidemiology, communication, decision making, quality of care, dissemination, and health disparities concern us at each point on the continuum.

The cancer control continuum is a useful framework on which to view plans, progress, and priorities. It helps us identify research gaps, where we must collaborate with others to have an impact, and where more resources may be needed.

The Cancer Control Continuum

Focus

Etiology

  • Environmental factors
  • Genetic factors
  • Gene-environment interactions
  • Medication (or pharmaceutical) exposure
  • Infectious agents
  • Health behaviors

Prevention

  • Tobacco control
  • Diet
  • Physical activity
  • Sun protection
  • HPV vaccine
  • Limited alcohol use
  • Chemoprevention

Detection

  • Pap/HPV testing
  • Mammography
  • Fecal occult blood test
  • Colonoscopy
  • Lung cancer screening

Diagnosis

  • Shared and informed decision making

Treatment

  • Curative treatment
  • Non-curative treatment
  • Adherence
  • Symptom management

Survivorship

  • Coping
  • Health promotion for survivors

Crosscutting Areas

  • Communications
  • Surveillance
  • Health Disparities
  • Decision Making
  • Dissemination of Evidence-based Interventions
  • Health Care Delivery
  • Epidemiology
  • Measurement

Adapted from David B. Abrams, Brown University School of Medicine