This chapter provides an overview of the mechanisms by which cancer develops and the importance of exogenous exposures in cancer causation. It describes the magnitude of cancer as a public health problem in the United States and globally, highlights temporal trends in cancer rates in the United States and variations in global cancer burden by country, income level, and region. Laboratory methods for identification of potential carcinogens are reviewed with emphasis on recent developments in toxicogenomics and high-throughput screening. The classification system used by the International Agency for Research on Cancer (IARC) in evaluation of potential carcinogens is described, and data are presented on occupational and environmental agents classified as “carcinogenic to humans” or “probably carcinogenic to humans.” Specific occupational and environmental carcinogens are discussed in greater detail. Topics of interest to clinicians and public health practicioners include the evaluation of occupational and community cancer clusters, primary and secondary prevention of occupational cancer, and four case studies related to cancer prevention and control and risk communication in diverse occupational settings.
Keywords: cancer rates, cancer trends, global cancer burden, carcinogen identification, laboratory methods, occupational carcinogen, environmental carcinogen, International Agency for Research on Cancer, cancer prevention, cancer control
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