What Areearly And Periodic Screening, Diagnostic, And Treatment Services

Early on detection of cancer greatly increases the chances for successful treatment. The ii components of early detection of cancer are early diagnosis (or downstaging) and screening. Early diagnosis focuses on detecting symptomatic patients as early as possible, while screening consists of testing healthy individuals to identify those having cancers before any symptoms appear.

Early diagnosis

Early on diagnosis programmes aim at reducing the proportion of patients who are diagnosed at a late stage. They have 2 primary components:

increased awareness of first signs of cancer, among physicians, nurses and other health care providers likewise equally amongst the general public; and
improved accessibility and affordability of diagnosis and treatment services, and improved referral from first to secondary and tertiary levels of care.

Early on diagnosis is specially relevant to cancers of the breast, cervix, mouth, larynx, colon and rectum, and skin.

Screening

Screening refers to the use of uncomplicated tests across a good for you population to identify those individuals who have a disease, merely do not all the same have symptoms. Examples include breast cancer screening using mammography or clinical chest exam, and cervical cancer screening using pap smears, human papillomavirus exam or visual inspection with acetic acid.

Screening programmes should be undertaken only when their effectiveness has been demonstrated, when resource (personnel, equipment, etc.) are sufficient to comprehend nearly all of the target group, when facilities exist for confirming diagnoses and for treatment and follow-upwardly of those with abnormal results, and when prevalence of the disease is high plenty to justify the effort and costs of screening.

Fifty-fifty when implemented properly, screening programmes are associated with undesirable effects which include:

falsely positive screening tests that issue in boosted testing, invasive diagnostic procedures and patient feet;
falsely negative screening tests that provide false reassurance and can result in delayed presentation/diagnosis when symptoms appear; and
over diagnosis/handling of preclinical cancers that could take never cause symptoms nor pose a serious wellness threat and which involve unnecessary treatment that injures the patient.

The importance of these harms varies according to the screening tests, population groups targeted for screening and quality of screening programmes.

Weighing the harms confronting the benefits of screening has led WHO not to recommend mammography screening in women less than 50 years of age. Based on the existing show, mass population screening can be advocated merely for cervical, chest and colorectal cancer.

Systematic prostate cancer screening of all men above a sure age using prostate-specific antigen (PSA) is non recommended by WHO. The high harm/benefit ratio has resulted in the abandonment of population-based PSA screening for prostate cancer in many countries of western Europe in the by years.

Distinguishing cancer screening from early on diagnosis

Early diagnosis requires ensuring rapid patient presentation, diagnosis and treatment equally soon as showtime symptoms announced. It is relevant to all types of cancer.

Screening, on the other hand, is relevant to a subset of cancer types only – namely cervical, colorectal and breast cancers, which together represent 28% of cancer cases in the WHO European Region. In the case of cervical cancer, screening enables cure at a precancerous stage of the affliction with minor surgical treatments. This is not the case for breast cancer, or for colorectal cancer screening by fecal occult blood exam.

Cancer screening and early detection of cancer

Barriers to early cancer diagnosis and treatment

Early diagnosis programmes focus on reducing delays betwixt the detection of start symptoms and treatment by ensuring that:

people are sensitized enough to consult wellness professionals every bit shortly as symptoms announced, without being delayed by whatsoever financial, logistical or psychosocial barriers;
the wellness staff consulted react appropriately and rapidly, thanks to acceptable training and clear referral guidelines; and
diagnostic and treatment services are accessible apace and deliver optimal quality at an affordable toll.

At all stages, barriers tin can reduce patients' chances of being diagnosed and treated quickly. These include poor cancer awareness amid the public; suboptimal knowledge at the primary health care level about cancer symptoms and/or adequate diagnosis follow-up; poor accessibility; low affordability and/or quality of diagnosis and treatment services (waiting lists, errors in diagnosis, administrative red tape, unclear referral pathways, etc.); and the many logistical, financial and psychosocial barriers preventing patients from accessing services rapidly.

A major objective of early diagnosis programmes is to reduce the prevalence of these barriers. This is also a prerequisite for implementing screening programmes, as to be successful they require rapid, acceptable-quality diagnosis follow-up and treatment for people screened positive.

Early diagnosis programmes are comparatively piece of cake and inexpensive to implement; since they cover symptomatic patients only, they are less all-encompassing than screening programmes that target entire populations.

Barriers to early cancer diagnosis and treatment