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DOI 10.1002/cncr.11252

AdamiH-O, HunterD, TrichopoulosD, editors. Textbook of cancer epidemiology. Monographs in epidemiology and biostatistics, volume 33. Oxford: Oxford University Press, 2002. Price: $75.00.

Melissa Bondy M.D.*, Lisa A. Newman M.D., M.P.H.*, * Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas.

The stated aim of this large and comprehensive volume is to report on what is established, new, and promising in the fascinating field of cancer epidemiology. The volume thus promises and delivers, in plain English, information and motivation. The editors' preface sets forth the thesis and a succinct description of the book, which is comprised of chapters from well-known epidemiologists from three continents, including six from the Karolinska Institute in Stockholm, Sweden and eight from Harvard University. The editors argue that disease control will depend on primary prevention rather than innovative treatments and that advances in genetics will add urgency to the study of the causal interaction of genes, environment, and lifestyle. The book thus is retrospective, covering the basics of incidence, epidemiologic approaches and methods, and site-specific malignancies, but also pointing out gaps in knowledge and contradictions, which plainly challenge researchers. This book was designed for everyone from students in the health and life sciences to health practitioners, and should be used for every cancer epidemiology course.

Not only is this book an excellent teaching text, it should be a useful text or reference book for investigators in the field because it has a balanced, straightforward organization in two parts. It opens with a discussion of the burden and what is known of the origins of cancer, its genetic epidemiology, its biomarkers, and concepts in and validation of epidemiologic studies. Part I acquaints readers who are new to the discipline or disease issues with the topic, thereby providing the background needed for Part II, which is devoted to cancer epidemiology by site-specific tumors. The site-specific chapters are of roughly equivalent length and each presents descriptive epidemiology, genetic and molecular epidemiology, and risk factors for each specific type of tumor. The tables and figures in each of these chapters illustrate incidence patterns or summarize results in the more-studied malignancies.

Although the pattern of discussion is transparent and tidy, findings and studies vary in specificity and authority, as the preface warned. It is to the credit of the editors and all the authors that what is not known, conflicting or inconsistent studies, or any lack of reliable information are treated as directly as although, logically, more briefly than, topics for which there is a degree of consensus. The larger issue raised by the many limitations of the studies discussed, namely the reliability of epidemiology itself, is discussed in the editors' epilogue.

The editors note that although epidemiology is far from being accepted universally as a successful science, it is their opinion that there is a current golden age of epidemiologic inquiry into the causes of malignancy. Although it is true that the discipline abounds with negative or inconclusive studies, even these help direct research into more probable risks and causes. The list of established risk factors, although a short table of 10 items, has been authenticated largely by epidemiologic studies. Furthermore, these are improving in method and gaining what may be termed optic power from statistical, diagnostic, genetic, and molecular techniques. The authors conclude that the discipline of cancer epidemiology has much more to contribute. So optimistic are the authors that they even predict their book will rapidly become out of date! However, until that time, this volume appears to be not only comprehensive and comprehensible but also encouraging, informed by the hope and belief that has informed its creation.