Approaches to surveillance of occupational cancer.

The overall number of deaths from cancer is increasing. The absolute magnitude of this increase is in debate. Unfortunately, we are unable to estimate the interactions between two or more agents such as cigarettes and asbestos. None of the appropriate studies is precisely able to know the exact exposure to carcinogens. Regardless of the percentage of cancers related to the workplace, the numbers are clearly clinically significant. It is important to present to physicians medical conditions which have an increased probability of resulting from occupational exposure. This will allow clinics, hospitals and health departments to seek evidence of changing patterns or clusters of listed diseases. Individual physicians with a high index of suspicion play an important role in detecting occupational cancers. The current state of the art is, that with rare exceptions, a good occupational history which contributes to a reasonable diagnosis with appropriate background information is the best way for the practicing doctor to detect occupational cancers. All health care providers should look beyond cigarettes as the only cause of cancer worth noting in order to implement primary preventive medicine strategies.