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Proposal for future uses in epidemiology for cohort studies on the prevention of work-related cancer.

A new use of the cohort method in cancer prevention is proposed involving individual collection of information on past exposure to dominating cancer determinants. It is assumed that it is possible to determine individual cancer risk and, subsequently, to estimate the individual risks of cause-specific cancers on the basis of accurate individual data on exposure to cancer determinants. Individuals at given risk levels should subsequently be assigned to defined risk categories to establish groups designed for risk-determined screening programs and risk-determined information intervention. As increased risk to work-related cancer is generally more strongly related to past than to current exposure, a large proportion of those who are at high risk are no longer employed and thus not in reach of occupational health physicians. Therefore, risk-determined intervention should be integrated into the daily work routines of both occupational health physicians and primary care physicians.