On page 1992 of this issue, you will find an article that exemplifies the 2003 Annual Clinical Focus on Prevention, an educational initiative of the American Academy of Family Physicians. The initiative is conducted in cooperation with the following organizations: the Agency for Healthcare Research and Quality, American Cancer Society, American College of Preventive Medicine, American Diabetes Association, American Heart Association, Centers for Disease Control and Prevention National Cancer Institute, and National Human Genome Research Institute. ACF 2003 elements are supported by educational grants to the AAFP from the following companies: Schering, Pharmacia Corporation, Aventis Pharmaceuticals, GlaxoSmithKline, Abbott Laboratories, Wyeth Pharmaceuticals, Aventis Pasteur, Inc., and AstraZeneca.

The program, which changes at the end of the calendar year, has focused during 2003 on primary prevention (lifestyle, healthy behaviors), secondary prevention (screening, early detection), tertiary prevention (prevention of complications), and prevention of medical errors (patient safety). Although AFP does not receive funding from the initiative, ACF articles appear throughout the year.

In an upcoming editorial on clinical preventive medicine, Ed Dismuke, M.D., of the Kansas University School of Medicine-Wichita, points out that one of the key strategies of the U.S. Department of Health and Human Services to improve the health of Americans is a focus on improving five major lifestyle factors: tobacco use, overweight/obesity, lack of physical activity, substance abuse, and irresponsible sexual behavior.

The ACF article in this issue ties in nicely with this theme. The authors, Barbara S. Apgar, M.D., M.S., Lauren Zoschnick, M.D., University of Michigan Medical School, Ann Arbor, Mich., and Thomas C. Wright, Jr., M.D., Columbia University College of Physicians and Surgeons, New York, N.Y., present a review of the 2001 Bethesda System Terminology for reporting cervical or vaginal cytologic diagnoses. The article will help physicians understand the revisions in statements of adequacy, general categorization, and interpretation/results.

The December 15 issue's cover article will review strategies for the primary prevention of stroke. The authors, Justin A. Ezekowitz, M.B.B.CH., M. Sc., University of Alberta, Edmonton, and colleagues, note that stroke is a leading cause of morbidity and mortality in North America. Primary prevention includes lifestyle modifications and measures to control blood pressure, cholesterol levels, diabetes mellitus, and atrial fibrillation.

The 2004 Caring for America's Aging Population ACF program, which begins in January, will cover three age groups: 50 and over, 65 to 80, and 80 and over. The initiative will address the psychosocial and physical changes associated with aging, multiple chronic health problems, management of common geriatric syndromes, and medications and drug interactions, and includes challenges of management across clinical settings and ethical issues. The 2004 ACF on aging is a program of the American Academy of Family Physicians in cooperation with the following companies: AARP, Agency for Healthcare Research and Quality, American Cancer Society, American Diabetes Association, American Geriatrics Society, American Heart Association, National Cancer Institute, and National Institute on Aging.

ACF 2004 elements are also supported by educational grants to the AAFP from the following companies: Merck/ Schering-Plough Pharmaceuticals, Merck & Co, Inc., Schering-Plough Pharmaceuticals, Aventis Pharmaceuticals, AstraZeneca, Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership, Bristol-Myers Squibb, Sanofi, Forest Pharmaceuticals, Inc., and Ortho Biotech.