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Does early screening reduce the cancer mortality rate?

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Does early screening reduce the cancer mortality rate?

As the number of cancer cases increase rapidly in almost every country in the world, cancer eradication is still one of the most consequential public health concerns of this current era. Prompt screening, appropriate diet and nourishment, and exercise could decrease and avoid at least 60% of all cancer cases. Lowering the cancer cases requires cumulative and homogenous efforts from all sectors of the health sector, as well as medical technology sectors and other professions. The earlier the cancer is detected, the greater the chances it can be treated before it spreads to other tissues or organs in the body and reduce the mortality rate caused by this disease.

What is cancer?

Cancer is general name for all the various illnesses characterized by the abnormal growth of cells which form tumors that can appear at different parts of the body. Some cancers can attack one organ and others spread all over the body. It is a very serious disease and kills many people annually. Unlike normal body cells, cancer cells do not know when to stop growing. They divide without control and replace nearby healthy cells by disturbing their normal activity and competing with them. They can grow into a neoplasm and conquer the normal cells.

What is cancer screening?

Cancer screening is checking a person for any form of cancer before a person has any symptoms.

There are different kinds of screening tests; screening tests include the following:

1.   Physical exams and history: Examination of the entire body is done to help doctors check for all general signs of the disease and overall health. The signs include lumps and anything unusual. Detailed patient, family, drugs, and lifestyle history will also help in the effective management of all cancer cases.

2.   Laboratory tests: The doctor takes the patient’s blood, urine, stool, and other substances in the body for more analysis. Laboratory tests help doctors determine what is going on within the patient’s body.

3.   Imaging procedure: Imaging makes it possible for health professionals to see places in the body that are difficult to see with the naked eye.

4.   Genetic test: Genetic mutation plays a part in the development of cancer. Scientists study the changes in genes or chromosomes. These changes may be a sign that a person is exposed or is at risk of having a specific disease or condition.

Screening tests have risks

Introducing the body to extreme radiation is very detrimental to the body and it puts the body at risk. Not all screening tests are helpful and most may have risk due to the exposure of the body to harmful radiation.

What causes cancer?

The appearance of cancer may be due to some factors; and just like many other illnesses, most cancers happen as a result of exposure to modifiable and non-modifiable risk factors. Modifiable risks are risks caused by a person’s lifestyle choices or unhealthy habits while unmodifiable risks are due to a person’s family history or inevitable circumstances.

 The modifiable risk factors include alcohol, being overweight or obese, diet and nutrition, physical activity, tobacco, ionizing radiation, workplace hazards, and infections. The non-modifiable risk factors also include age, cancer-causing substances (carcinogens), genetics, and the immune system. See figure 2 below.

Early screening reduces the cancer mortality rate

At least some types of cancers are preventable giving us every hope to champion healthy choices and prevention strategies for all so that we have the best chances to detect, prevent, and reduce our cancer risks. According to the World Health Organization; at least one-third of all the common cancers are preventable through healthy eating, maintaining a good body weight, and being physically active by engaging in a lot of sporting activities. Early screening of cancer significantly makes the chances of productive treatment higher and it aims at detecting patients exhibiting symptoms as early as possible. Any delays in accessing cancer care are common with end-stage clinical presentation precisely in lower resourceful settings and defenseless society. The results of delayed cancer care include the low probability of survival, greater morbidity of treatment, and expensive health care delivery resulting in unfortunate deaths and permanent disability from cancer.

The World Health Organization Views on every screening of Cancer

The WHO states that early screening focuses on reducing the number of patients who are diagnosed at a late stage. There are three (3) steps:

·     Awareness and accessing care

To improve awareness and access to care, a strategic approach should be employed that takes into consideration, empowerment, and engagement linked to integrate people-centered services at all levels of care. This will include education and destigmatization.

·     Clinical evaluation, diagnosis, and staging

Efficient diagnostic capacity and improving referral mechanisms can subdue a common barrier to early diagnosis. All departments in the health care system should be equipped with enough skills and knowledge to identify cancer symptoms and carry out the appropriate medical test. Diagnostic tests are very important in the diagnosing of cancer cases. Hence, a patient should generally not begin cancer treatment, unless the right diagnosis and pathologic confirmation are done. Lastly, effective management of cancer cases requires an equipped facility with high quality, multi-disciplinary cancer care.

·     Access to treatment

Effective treatment would depend on several factors such as financial, geographical, logistical, and socio-cultural barriers. Holistically, all these factors would be required to ensure there is a timely cancer treatment.

Decision making regarding early screening relies solely on several factors, including the cancer being addressed holistically, the risks of developing cancer among specific population and the health system capacity, that includes health professionals, health information and technology, genetic and other medical devices.

What cancer screening statistics tell us?

Lead-time bias occurs when screening finds cancer earlier than that cancer would have been diagnosed because of systems but the earlier diagnosis does nothing to change the course of the disease (National Cancer Institute, 2018) - See the graphic for further explanation.

Another important topic that you cannot do without in cancer screening is length bias and over diagnosis. Length bias is a form of selection bias where a lapse of the disease’s life span is made due to the analogous surplus of cases detected with no symptoms; grow slowly while fast progressing cases are discovered after giving symptoms. (National Cancer Institute, 2018)- See the graphic for further explanation. 

Age related mortality rate in certain populations. Age-standardized rates are used in the tables.

Age is an essential determinant or risk factor in the development of cancer. The rate of mortality is strongly proportional to the age. The older one becomes the higher one develop age related conditions like cancer, non-communicable diseases and others. The table depicts the rate of disease among certain population when they fall within certain category of age range.

The rate of cancer in some parts of the world: male and female.

Australia came out as of the countries with the highest incidence rate of cancer for both men and woman at a rate of 468.0 people per 100,000.

The age specific rate was at lowest of 320 per 100,000 for twelve countries: Australia, Denmark, Norway, New Zealand, Ireland, Hungary, the US, Belgium, France (metropolitan) the Netherlands, Canada, and New Caledonia (France).

The countries in the top 12 come from North America, Oceanssia and some part of Europe.

A brighter future

Innovative technologies, such as low-dose helical computed tomography, mammography, breast MRI, a transvaginal ultrasound, virtual colonoscopy, and sigmoidoscopy, are all minimally invasive methods to visualize and assess difficult-to-reach areas in the body.

Advanced medical technologies will allow us to go every inch by providing the necessary tools to treat patients. Doctors collect patients' stool, fetoprotein blood, and perform other tests such as Pap test, CA-125 test, PSA test, and skin exams to diagnose patients of the type of cancer growing in their body.

Advanced medical technologies are making it possible for doctors to detect, diagnose, and treat all forms of cancer at more simple and safe ways.

Conclusion

Based on this, we encourage policymakers to act now to reduce the burden of cancer by implementing policies that enable early screening. Advanced medical technologies are making it more easy and simple to save patients’ lives. Let’s encourage every patient to have access to early screening without further delay. The result of the disease can be reduced significantly by diagnosing cases as early as possible thus increasing the opportunity for successful surgery or treatment. In this short video Dr. Guilia Veronesi, Dr. Gaetano Roco, and Dr. Karl Klinger share with us an insightful view on the varying dimensions of this disease and what can be done in the future to tackle it.

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Olha Polishchuk
Content manager
May 27, 2020
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