Position statement: screening
The problem
Screening in relation to cancer can take several forms:
- Screening for a cancer that has already started to develop
- Screening for a pre-cancerous condition
- Genetic screening to identify increased risks of particular cancers.
There are currently screening programmes for cervical, breast and bowel cancer. Screening for lung cancer is being rolled out alongside the new NHS lung health checks.[1]
Policy and strategy for screening, including cancer screening, is largely set by the UK National Screening Committee. Recently the Committee has been given an extended remit to cover targeted and stratified screening, as well as population screening, which will improve its impact on population health. It will also enable the Committee to advise on important new technologies such as multi cancer early diagnostic tests. However, there is still scope for more effective screening to be introduced.
Genetic screening can be expected to become more common, as the cost of genetic testing reduces further and genetic causes of many diseases are better understood.
Recommendations
Scope for improving existing screening programmes should be thoroughly explored. Their effectiveness is sometimes surprisingly hard to identify, and data on the numbers of lives saved are often not firm.
Expanding the scope of some of the programmes should be considered: a quarter of breast cancer cases occur in women aged 75 and over , but the screening programme only covers women aged 50 to 71.[2] Similarly, the bowel screening programme covers people aged 60 to 74, but with nearly 60% of all cases occurring in people aged over 70, many will be missed by screening.[3]
Information on making healthy lifestyle choices should be distributed alongside cancer screening letters and notices: while individual responsibility can only ever be part of the solution, these established communication channels may as well be utilised.
As more people get themselves tested for more genetic risks, it is important that genetic counselling is available for anyone using these services.[4]
About CancerWatch
CancerWatch is an organisation made up of people whose lives have been affected by cancer, who are passionate about eliminating preventable cancers in the future.
June 2023
[1] https://www.cancerresearchuk.org/about-cancer/lung-cancer/getting-diagnosed/lung-health-checks
[2] https://breastcancernow.org/about-us/media/facts-statistics#:~:text=Eight%20out%20of%2010%20cases,will%20be%20in%20their%2040s
[3] https://www.bowelcanceruk.org.uk/about-bowel-cancer/bowel-cancer/
[4] https://www.nice.org.uk/guidance/cg164/ifp/chapter/genetic-counselling-and-genetic-testing