the effect of these low screening rates is seen in the modest impact that these screening programmes have had in diagnosing cancers at an earlier and more easily treatable stage with the exception of breast cancer given increasing rates of smoking obesity and alcohol abuse including among children more effective means of primary prevention of ill health must be found additionally although guidelines for secondary prevention of cardiovascular risk exist nothing is known about adherence to them in terms of preventive interventions for cancer linking screening data to clinical outcomes held in the national cancer registers is an obvious necessary first step