Screening is defined by the use of clinical and laboratory methods to detect disease early in asymptomatic individuals with the aim of decreasing morbidity and mortality. For cancer screening a test would detect cancer before it would occur or at least at its earliest stage.

All the cancers are not suitable for screening; those cancers which are have high prevalence in a detectable preclinical stage, high cure rate with early detection and availability of good screening tests with high sensitivity, specificity, low cost, little discomfort to patient.

Common screening methods in Cancer

Cervical Cancer:

Cervix cancer is the most common cancer in females in India. Still we lack behind in educating and achieving proper screening procedures available for our people.The best part is if cancer cervix is diagnosed in routine screening it is 100% curable.

As per American cancer society guidelines

• All women should begin cervical cancer screening about 3 years after they begin having vaginal intercourse, but no later than 21 years old. Screening should be done every year with the regular Papanicolaou (PAP).
• Beginning at age 30, women who have had 3 normal Pap test results in a row may get screened every 2 to 3 years.
• Women older than 30 may also get screened every 3 years with either the conventional or liquid-based Pap test, plus the human papilloma virus (HPV) test.
• Women 70 years of age or older who have had 3 or more normal Pap tests in a row and no abnormal Pap test results in the last 10 years may choose to stop having Pap tests.
• Women who have had a total hysterectomy (removal of the uterus and cervix) may also choose to stop having Pap tests, unless the surgery was done as a treatment for cervical cancer or pre-cancer. Women who have had a hysterectomy without removal of the cervix should continue to have Pap tests.

Breast Cancer:

In my previous posts i have elaborated about the different screening techniques and its importance in Breast cancer.

• Monthly self-breast examination above 20yrs
• Clinical breast examination every 3yrs between ages 20 – 39, and yearly after 40 years.
• Mammography yearly from age 40.

Colorectal cancer and polyps

As per American cancer society guideline

Beginning at age 50, both men and women should follow one of these testing schedules:

Tests that find polyps and cancer

• Flexible sigmoidoscopy every 5 years*, or
• Colonoscopy every 10 years, or
• Double-contrast barium enema every 5 years*, or
• CT colonography (virtual colonoscopy) every 5 years*

Tests that primarily find cancer

• Yearly fecal occult blood test (gFOBT)**, or
• Yearly fecal immunochemical test (FIT) every year**, or
• Stool DNA test (sDNA), interval uncertain**

In India inspite of very high incidence of different cancers we still lack the proper public awareness, lack of infrastructure, and infact the lack of self-motivation for cancer screening. Though the scenario is going towards a good trend of public awareness still we are far away from routing screening procedures. Some more initiatives from people, govt and health institutions can make a difference.

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Related articles

• What You Need to Know About Cervical Cancer (prodigyempire.wordpress.com)
• An Annual Pap Test Saved My Life (blogher.com)
• Vinegar test cut cervical cancer deaths in India by one-third, could help many poor countries: study (vancouversun.com)