All of us know that prevention is better than cure and its importance cannot be overemphasized. However, not every disease is preventable and screening provides us with the second best option of catching them early. Although there are various definitions for screening it can simply be summed up as detecting disease early in asymptomatic (those without any symptoms) individuals.
Screening is meant to decrease mortality from the disease in question and it can be utilized effectively for fairly common health problems where cost effective screening methods and clinically effective early institution of treatment is possible.
It is estimated that screening results in mortality reduction ranging from 3 to 35 percent depending on various factors. Cervical cancer is an excellent example of mortality reduction as a result of screening. Apart from reduction in deaths from cancer, screening also gives us an opportunity to detect cancer at a stage where minimal treatment is required. For example, a very early breast cancer may just require a small surgery and the patient may be able to avoid chemotherapy and radiation therapy completely. Also, most of the screen detected cancers would require less mutilating operations with much lesser hospital stay and the cost of treatment. However, you must discuss the pros and cons of any screening investigations with your oncologist before having it done.
Screening can be broadly divided into having following components:
Screening proven to be beneficial
Screening not proven to be beneficial
Screening beneficial is high-risk region or population
General Guidelines (for normal risk general population)
High risk individuals by virtue of their family history, habits or any other risk factor need to be counseled separately and usually require more often and more intense screening methods.
Breast Cancer screening
Cervical Cancer Screening
Should begin approximately 3 years after beginning of vaginal intercourse.
It includes pelvic examination every 3 years and Pap smear yearly for three years and, if found normal for three consecutive years, thereafter the frequency can be decreased. If pap smear is combined with HPV DNA testing the frequency of screening can be decreased and it can safely be done every three years.
Colon Cancer screening
One of the following is recommended for a normal risk individual above 50 years of age:
Individuals with family history of colon cancer or personal history of precancerous lesions like polyps (small benign growths in colon / rectum) require the screening to begin at a younger age and done more frequently depending on the level of risk.
Studies have been contradictory. Nonetheless, a combination of clinical examination and serum PSA test (blood test) may be beneficial in reducing deaths for individuals between the age of 55 and 69 years.
Screening is an effective tool to diagnose cancers at a pre-clinical stage thereby providing an opportunity to attain high cure rates by using less aggressive treatment options thus improving the quality of life as well. Notwithstanding the utility of screening, one must weigh the benefits and risks carefully before undergoing screening.
Warning symptoms / signs of cancer
Please remember, all these warning signs and symptoms can also be because of benign (non-cancerous) diseases. Nonetheless, they need to be investigated to find and treat the cause.