The brave new world--what can we realistically expect to achieve through cancer control early in the new millennium?

Cancer control requires strategic planning, and thus knowledge about the trends of incidence and mortality associated with cancer as well as future projections, in order that appropriate decisions on priorities can be made. Cancer prevention requires tobacco control and dietary modification. Screening should utilize only effective strategies. The trends in Canada are expected to be mainly favourable by the year 2020, apart from rising trends in non-Hodgkin's lymphoma. Tobacco control policies in Canada are having an impact, while dietary modification is probably having an impact on colorectal cancer incidence. Screening for cancer of the cervix has achieved maximum impact with present levels of compliance, but as yet there is no evidence of an impact of breast screening. Priority for the future will have to be placed on prevention, especially on encouraging young adults to quit smoking and on dietary modification starting at young ages, and care should be taken with cost-effective application of screening.