Screening

Question 1

Does the ideal screening test exist?

Answer 1

No - they are normally expensive, and not specific enough

Question 2

Advantages of screening?

Answer 2

Reduction in mortality by detecting early disease when its curable
Less radical treatment hence reducing morbidity
Saving on health service resources by increased cure rates
Reassurance given by a negative test

Question 3

Disadvantages of screening

Answer 3

Increased length of anxiety and morbidity if no intervention possible
Over-investigation of false positive cases with assoc. morbidity
over-treatment of borderline cases
False reassurance from a false negative test
Cost of screening a large population

Question 4

How can cancer screening programmes be more successful?

Answer 4

1. limit the screening to at-risk populations - improves overall sensitivity and specificity
2. develop an effective infra-structure for awareness

Question 5

Which cancers have established screening programmes?

Answer 5

cervical, breast, colorectal

Question 6

How is cervical cancer screened for?

Answer 6

women 25-49 are invited every 3 years, 49-64 is every 5 years
Starts at 20 in Scotland in Wales

Question 7

How is breast cancer screened for?

Answer 7

Regular mammography is offered to all woman between the ages of 50 and 70 every 3 years

Question 8

How is colorectal cancer screened for?

Answer 8

Men and women are offered bowel screening, using faecal occult blood, every 2 years from 60 to 69 (moving to 74)

Question 9

How are people with ulcerative colitis screened for colorectal cancer?

Answer 9

Screen with existing management plan, including regular colonoscopies