Cancer is a cluster of diseases characterized by an uncontrollable growth of abnormal cells that can affect almost any tissue or body organ. Globally, cancer is the second leading cause of mortality. As per a WHO report, breast, cervical, lung, colorectal, and thyroid cancer occur commonly in women, while prostate, colorectal, lung, liver, and stomach cancer are common in men.

From an economic and emotional perspective, the burden of cancer is increasing globally with each passing day, exerting a substantial strain on individuals, communities, and healthcare systems along with the physical suffering it entails.

Approximately 70% of cancer deaths occurring in low or middle-income countries are due to scarcity of resources for cancer diagnosis and treatment. Early screening in cancer detection can diagnose the disease at an early stage, and accordingly, cancer can be treated or cured depending on the stage of the disease.

WHO considers the following stages of its Cancer Control Program: Prevention, Early Detection, Diagnosis & Treatment, and Palliative Care. 

Cancer detection usually has two components: Early diagnosis and screening. Early diagnosis aims to detect patients with symptoms at the earliest possible stage. Screening typically focuses on healthy individuals while there are no visible symptoms yet.

Early screening includes systematic application of tests in healthy individuals or populations to identify individuals with pre-cancerous lesions or very early stage cancers while the disease is yet asymptomatic. These identified individuals require further investigation and follow-ups. Mammography for breast cancer screening, Pap smears and Human Papillomavirus (HPV) for cervical cancer screening are few examples of screening tests done in women.

Early screening in a population can be through an organized program or an opportunistic screening. A scheduled program of early screening follows a protocol with predefined systematic approaches, while opportunistic screening is unsystematic applications of screening tests during routine health services.

Early screening is the right step

Over the past few decades, early screening of cancers has played a pivotal role in devising strategies for preventing and treating cancers. The American Cancer Society (ACS) has continually promoted early detection of both asymptomatic and symptomatic cancers. 

ACS recommends adults at average risk to undergo screening for breast, cervical and colorectal cancers; adults at high-risk lung cancers to undergo lung cancer screening, and men are recommended to undergo prostate screening. These screenings aim to maximize the application of evolving screening techniques and to design a blueprint for the future of cancer control strategies.

In regions with non-availability of early screening and detection resources, cancers are usually diagnosed at advanced stages where the survival rates are very low, and the treatment costs are high. Few other factors for late diagnosis include:

• Lack of awareness.
• Not getting appointments for diagnosis 
• No access to adequate healthcare
•  Complex nature of screening journeys.

Remember, “Earlier the better”. Studies have shown that most cancers are responsive to early detection. An early detected cancer treated with an appropriate regimen increases the survival rate beyond five years in comparison to late diagnosis. Early diagnosis has also been shown to significantly increase the quality of life (QOL) and reduce disease burden and treatment cost.

Range of Screening Tests

The screening tests range varies from blood tests to medical imaging to biopsy. However, the results are not always reliable and synchronized. These include invasive and non-invasive techniques, and some tests may even cause pain or bleeding (e.g. biopsy). Another limitation is that for few tests, the results are not readily available. In addition, there could be false positives or false negatives. 

Over-screening and associated exposure is another limiting aspect of early cancer screening. However, studies have shown that the benefits of early screening outweigh the risks associated with these techniques.

Union for International Cancer Control (UICC) had developed the theme of “I Am and I Will,” which intends to create awareness among individuals, communities, and government bodies for access to early cancer screening and detection programs.

It is important to be aware that we are custodians of our own body. It pays to be vigilant for any abnormality, symptoms or bodily changes that we may notice in the course of our daily activity. We also need to be more aware and educate ourselves about cancer, its detection & diagnosis, treatment and management. Early screening is the key. We also should take into consideration our risk factors such as family history, tobacco use, alcohol use, overexposure to the sun, our diet, lifestyle and obesity factors. 

Conclusion

With advancements in screening techniques and cancer therapies over the last decade, the chances of effective prevention have increased significantly. The adage “Early bird catches the worm”, works effectively in dealing with cancer. Early detection and its associated benefits of early diagnosis/screening and treatment will go a long way to increasing the chances of recovery. 

Studies show that screening increased survival rate, QOL while bringing down physical pain, emotional trauma and financial burden in the treatment. Let us remember, that when it comes to the big C, “Early Detection will lead to Prevention.”