Cancer Screening & Detection
Best Cancer Screening and Detection Service
Cancer screening tests aim to find cancer before it causes symptoms and when it may be easier to treat successfully. An effective screening test is one that
- finds cancer early
- reduces the chance that someone who is screened regularly will die from the cancer
- has more potential benefits than harms (possible harms of screening tests include bleeding or other physical damage, false-positive or false-negative test results, and overdiagnosis—the diagnosis of cancers that would not have caused problems and did not need treatment)
Recommended Screening Tests:
- Breast cancer screening: Screening mammography has been shown to reduce deaths from breast cancer among women ages 40 to 74, especially those ages 50 to 69. Expert groups generally recommend that screening starts at age 50 for women at average risk.
- Cervical cancer screening: Human papillomavirus (HPV) tests and Pap tests are recommended cervical cancer screening tests that can be used alone or in combination. These tests prevent the disease because they allow abnormal cells to be found and treated before they become cancer. Expert groups generally recommend that testing begins at age 21 and end at age 65 (for women who have had adequate prior screening and are not otherwise at high risk for cervical cancer).
- Colorectal cancer screening: Several screening tests, including colonoscopy, sigmoidoscopy, and stool tests (high-sensitivity fecal occult blood tests and stool DNA tests) have been shown to reduce the risk of dying from colorectal cancer. In addition to detecting colorectal cancer early, colonoscopy and sigmoidoscopy can help prevent the disease from developing. That’s because these tests can find abnormal colon growths (polyps) that can be removed before they become cancer. Expert groups generally recommend that people who are at average risk for colorectal cancer have screening with one of these tests at ages 45 or 50 through 75.
- Lung cancer screening: Low-dose helical computed tomography, a type of CT scan, has been shown to reduce lung cancer deaths among heavy smokers. Expert groups generally recommend screening of some current or former heavy smokers at ages 50 to 80.
Other Screening Tests:
- Alpha-fetoprotein blood test
- Breast MRI
- CA-125 test
- Clinical breast exams and regular breast self-exams
- Multicancer early detection tests
- PSA test
- Skin exams
- Transvaginal ultrasound
- Virtual colonoscopy
Distinguishing cancer screening from early diagnosis:
Early diagnosis requires ensuring rapid patient presentation, diagnosis and treatment as soon as first symptoms appear. It is relevant to all types of cancer.
Screening, on the other hand, is relevant to a subset of cancer types only – namely cervical, colorectal and breast cancers, which together represent 28% of cancer cases in the WHO European Region. In the case of cervical cancer, screening enables cure at a precancerous stage of the disease with minor surgical treatments. This is not the case for breast cancer, or for colorectal cancer screening by fecal occult blood test.
Barriers to early cancer diagnosis and treatment:
Early diagnosis programmes focus on reducing delays between the detection of first symptoms and treatment by ensuring that:
- people are sensitized enough to consult health professionals as soon as symptoms appear, without being delayed by any financial, logistical or psychosocial barriers;
- the health staff consulted react appropriately and rapidly, thanks to adequate training and clear referral guidelines; and
- diagnostic and treatment services are accessible rapidly and deliver optimal quality at an affordable cost.
At all stages, barriers can reduce patients’ chances of being diagnosed and treated quickly. These include poor cancer awareness among the public; suboptimal knowledge at the primary health care level about cancer symptoms and/or adequate diagnosis follow-up; poor accessibility; low affordability and/or quality of diagnosis and treatment services (waiting lists, errors in diagnosis, administrative red tape, unclear referral pathways, etc.); and the many logistical, financial and psychosocial barriers preventing patients from accessing services rapidly.
A major objective of early diagnosis programmes is to reduce the prevalence of these barriers. This is also a prerequisite for implementing screening programmes, as to be successful they require rapid, adequate-quality diagnosis follow-up and treatment for people screened positive.
Early diagnosis programmes are comparatively easy and inexpensive to implement; since they cover symptomatic patients only, they are less extensive than screening programmes that target entire populations.