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Weekly magazines, newspapers, web sites and radio andtelevision interviews constantly bombard us with fantastic pos-sibilities for prevention, early diagnosis and cures for differ-ent diseases, among which a wide diversity of cancer typesfeature prominently. At the same frequency, we see that theinterest in publicizing proposals for promotions, diagnostictests and treatments is linked to strong commercial interests.Behind the proposals for products with little or no scientificgrounding, from skin protection lotion to latest-generationcomputerized tomography scanners, a variety of interests arehidden. Our reaction is to disavow the interminable num-bers of miracles that are proclaimed.The main criticism of such proposals is that they do notfulfill some minimum requirements for them to be transformedinto public healthcare actions, such as: (1) epidemiologicalimportance and relevance: high and increasing rates of diseaseincidence, with concentration among young age groups; (2)existence of preventive and early diagnosis measures that areavailable with an appropriate cost-benefit relationship; (3) ca-pability for altering the natural course of the disease throughtreatment that is not necessarily cheap, but is accessible.Considering these theoretical precepts, the prevention andearly diagnosis of cancer of the colon and rectum should al-ready be forming part of public healthcare practices, at least inthe State of Sao Paulo. Let us examine the facts. Epidemiological importanceAmong the causes of death due to cancer in the State ofSao Paulo in the population aged over 40 years, cancer of thecolon and rectum constitutes 7.7% and is the fourth-largestcause after lung, stomach and breast cancer. Over the last twodecades, the mortality rate due to cancer of the colon and rec-tum has significantly increased, even when adjusted for age. In1980, the rate (deaths per 100,000 inhabitants) was 15.9, andit reached a peak of 21.1 in 1998. The most significant in-creases were in the age group over 60 years old.

The noise stops you from hearing good music: the possibilities for a mortality reduction program for cancer of the colon and rectum in São Paulo