Objectives
  • To recognise population-wide clinical problems associated with cancer and translate this perspective into meaningful context for an individual patient

  • To identify comorbid conditions and understand their trends from a population level and the frequency of being associated with malignancy

  • To engage in activities geared at raising community awareness and counselling patients and their next-of-kin in terms of disease prevention

  • To list the available cancer-specific screening tests and identify which populations each is recommended for

  • To acknowledge the role of genetic, demographic and environmental risk factors in oncogenesis

  • To define and describe types of chemoprevention and to list specific populations they are used in

 
Awareness
  • Appreciation of the fundamental difference between statistical probabilities for a given population in comparison to an individual patient

  • Recognition that, if patient counselling is based on mere statistics, the actual impact of these numbers for a given patient may be of limited value

  • Recognition that patients have the right to make poor health decisions as long as they are adequately informed about potential negative health effects

  • Awareness of Hill's criteria for causation

 
Knowledge
  • Knowledge of cancer statistics such as incidence and survival for main demographic groups, nationally and globally

  • Understanding of the impact of prevalence on sensitivity and specificity

  • Understanding of the difference between efficacy and effectiveness as end points in clinical trials

  • Knowledge of the accuracy of screening tests employed

  • Familiarity with situations where screening has a well-defined role and scenarios where the role is unclear or not yet defined

  • Understanding that screening studies are subject to multiple biases, including healthy volunteer selection bias, lead time bias and overdiagnosis

  • Understanding of confounding and effect modification and their impact on interpreting population-based data

  • Understanding of epidemiological descriptors (eg, incidence, prevalence) and risk factors for cancer

  • Familiarity with hereditary cancer syndromes associated with specific germline gene mutations

  • Understanding of efforts to promote community awareness of early cancer detection and prevention

 
Skills
  • Ability to use biomarkers in oncology research and clinical practice

  • Ability to integrate molecular pathological and other biomarkers into daily practice

  • Ability to define primary, secondary and tertiary cancer preventive measures, and to describe the relative value of each

  • Ability to identify the biases associated with screening studies

  • Ability to distinguish between incidence and prevalence; sensitivity and specificity; and absolute risk and relative risk

  • Ability to describe lifestyle and dietary habits that increase one's risk for developing cancer

  • Ability to communicate population statistics appropriately to individual patients

  • Ability to critically analyse the results from descriptive and analytical observational studies and clinical trials

  • Ability to identify the malignancies for which screening is recommended and which patient populations screening is offered to

  • Ability to recognise the indications for genetic counselling and gene mutation testing when hereditary cancer syndromes are suspected

  • Ability to identify chemopreventive measures that are available for breast, colon, prostate, head and neck, and gynaecological cancers

  • Ability to define the concept of overdiagnosis and describe a clinical scenario this applies to

  • Ability to define lead time bias and explain a scenario where this fundamental concept can have an impact on survival