- CCA —
- clear cell adenocarcinoma
- DES —
Although the basic tenet of medicine is “First, do no harm,” history is filled with good intentions that were at best unhelpful and at worst harmful. Because medicine seeks to cure afflictions, there is an overwhelming desire on the part of health providers and patients to administer treatment. In certain settings, treatment can be reasonable despite a risk of adverse consequences: for example, if the disease is cured or its morbidity abated and the treatment consequences are less disabling than the disease itself.
In the absence of overt disease, the question of whether to apply an intervention is far more challenging. The safety of interventions must be weighed against the population’s level of risk, the morbidity and/or mortality associated with the disease, and the intervention’s efficacy (eg, BRCA1 mutation, mastectomy, reduced breast cancer risk). Interventions must meet an especially high standard of safety and efficacy …
Address correspondence to Rebecca Troisi, ScD, Epidemiology and Biostatistics Program, Office of the Director, Division of Epidemiology and Genetics, National Cancer Institute, 9609/7E578, 9609 Medical Center Dr, Rockville, MD 20850. E-mail: