Early detection of cancer, the goal of screening

Despite significant advances in screening and therapeutics of cancer, the global instability caused by the Covid-19 pandemic has hit the proceedings hard.

Image used for representational purpose only. 

The goal of screening and early detection is to cure cancer by catching the malignancy or its precursor lesion at an early stage prior to the onset of symptoms, as at this stage, the treatment is most effective.
Screening – particularly in prostate, breast, cervical, and to a certain extent, head, neck and colon cancers may help detect cancer at an early stage. Initial studies did show significant impact in terms of reducing mortality, especially in breast and cervical cancers.

Robust screening programmes

• Despite significant advances in screening and therapeutics of cancer, the global instability caused by the Covid-19 pandemic has hit the proceedings hard. This may have a long lasting impact on cancer outcomes
• Lockdowns and the fear of contracting the virus have disrupted screening programmes worldwide and India is no exception
• Advanced stage cancers are typically treated with palliative chemotherapy, immunotherapy and targeted therapy
• These can financially burden individuals, families and the healthcare system, especially where health insurance penetration is low
• Robust screening programmes are the way forward to early diagnosis and better cure rates
  

Downside of aggressive screening

• Over-diagnosis (false positives and over-investigation) leads to over-treatment of low-risk cancers, which would otherwise not have developed into a serious health problem
• Over-treatment not only represents an inefficient use of health resources, but may also produce long-term physical and psychological side effects in patients

Pertinent questions to be asked

• Are we decreasing the number of cancers diagnosed at a late stage?
• Are we reaching high-risk populations?
• Are we avoiding over-diagnosis?

Benefits of early screening

Patients have more treatment options with a less complex and complicated approach. This not only allows for affordable healthcare, but also saves money and resources of the healthcare system

For example, lung cancer claims 1.8 million lives every year worldwide. Yet, very few cases are diagnosed in early and curable stage

Early detection by cancer screening is an economic as well as a humanitarian investment

It offers a very good chance of cure and long-term survival

Patients can have a more fulfilling life, in terms of their work, earnings and spending quality time with their family in a healthy way

It will eliminate healthcare costs significantly, which otherwise would have to be borne by the healthcare system down the road

(Dr Nikhil S Ghadyalpatil, senior consultant medical oncologist & hemato-oncologist, Yashoda Hospitals Hyderabad)