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A blueprint for cancer screening and early detection: Advancing screening's contribution to cancer control.

Literature Information

DOI	10.3322/caac.21550
PMID	30452086
Journal	CA: a cancer journal for clinicians
Impact Factor	232.4
JCR Quartile	Q1
Publication Year	2019
Times Cited	49
Keywords	breast neoplasms, cervical neoplasms, colorectal neoplasms, lung neoplasms, mass screening
Literature Type	Journal Article
ISSN	0007-9235
Pages	50-79
Issue	69(1)
Authors	Richard C Wender, Otis W Brawley, Stacey A Fedewa, Ted Gansler, Robert A Smith

TL;DR

This research highlights the significant impact of cancer screening on reducing incidence and mortality for various cancers since the mid-20th century, but it also identifies shortcomings in access and the implementation of advanced technologies. The authors propose a comprehensive blueprint to enhance cancer screening efforts and ensure better investment in innovative technologies to maximize the potential benefits of early detection and treatment.

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breast neoplasms · cervical neoplasms · colorectal neoplasms · lung neoplasms · mass screening

Abstract

From the mid-20th century, accumulating evidence has supported the introduction of screening for cancers of the cervix, breast, colon and rectum, prostate (via shared decisions), and lung. The opportunity to detect and treat precursor lesions and invasive disease at a more favorable stage has contributed substantially to reduced incidence, morbidity, and mortality. However, as new discoveries portend advancements in technology and risk-based screening, we fail to fulfill the greatest potential of the existing technology, in terms of both full access among the target population and the delivery of state-of-the art care at each crucial step in the cascade of events that characterize successful cancer screening. There also is insufficient commitment to invest in the development of new technologies, incentivize the development of new ideas, and rapidly evaluate promising new technology. In this report, the authors summarize the status of cancer screening and propose a blueprint for the nation to further advance the contribution of screening to cancer control.

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Primary Questions Addressed

1. What specific advancements in technology could enhance the effectiveness of current cancer screening methods?
2. How can we ensure equitable access to cancer screening technologies among diverse populations?
3. What role do patient education and awareness play in improving participation rates in cancer screening programs?
4. In what ways can new ideas and innovations in cancer screening be incentivized to accelerate their development and implementation?
5. How do risk-based screening approaches differ from traditional methods, and what potential benefits do they offer in cancer detection?

Key Findings

1. Research Background and Purpose: The study addresses the critical role of cancer screening in reducing the incidence, morbidity, and mortality associated with various cancers, including cervical, breast, colon, rectal, prostate, and lung cancers. Since the mid-20th century, evidence has shown that early detection through screening can significantly improve patient outcomes by allowing for the treatment of precursor lesions and invasive disease at earlier, more manageable stages. However, the authors highlight that despite advancements in technology and the potential for risk-based screening, there remains a gap in fully realizing the benefits of existing screening technologies. The purpose of this report is to evaluate the current landscape of cancer screening and propose a comprehensive blueprint aimed at enhancing the role of screening in cancer control efforts.

2. Main Methods and Findings: The authors conducted a thorough review of the current state of cancer screening practices, identifying existing barriers to access and quality of care. They assessed the implementation of screening programs and the technological advancements in the field. Key findings indicate that while significant progress has been made, there are still substantial challenges that need to be addressed, including inadequate access to screening for target populations, insufficient investment in new technology development, and a lack of incentives for innovative ideas. The report emphasizes the need for a more coordinated approach to ensure that all individuals benefit from state-of-the-art screening and care.

3. Core Conclusions: The report concludes that to maximize the impact of cancer screening on public health, there must be a strategic overhaul in how screening programs are developed and implemented. This includes enhancing access to screening for underserved populations, fostering innovation in screening technologies, and creating a robust framework for the rapid evaluation and integration of new methods. The authors argue that a well-structured blueprint for cancer screening could significantly improve early detection rates and ultimately lead to better cancer control outcomes.

4. Research Significance and Impact: The significance of this research lies in its potential to inform policy and practice in cancer screening and prevention. By outlining a blueprint for advancing cancer screening, the authors provide a roadmap that could lead to more effective cancer control strategies, reduced healthcare disparities, and improved survival rates for patients. The findings underscore the importance of investing in both existing and innovative screening technologies, as well as the need for collaborative efforts among stakeholders to ensure that advancements in cancer detection translate into meaningful public health benefits. Ultimately, the proposed blueprint aims to enhance the effectiveness of screening programs nationwide, thereby transforming the landscape of cancer prevention and treatment.

Literatures Citing This Work

1. Personalized Risks of Over Diagnosis for Screen Detected Prostate Cancer Incorporating Patient Comorbidities: Estimation and Communication. - Roman Gulati;Sarah P Psutka;Ruth Etzioni - The Journal of urology (2019)
2. The Advent of Salivary Breast Cancer Biomarker Detection Using Affinity Sensors. - Imad Abrao Nemeir;Joseph Saab;Walid Hleihel;Abdelhamid Errachid;Nicole Jafferzic-Renault;Nadia Zine - Sensors (Basel, Switzerland) (2019)
3. Toward precision medicine based on the molecular landscape of carcinoma in situ of the bronchus: is it realistic for patients with pre-invasive lung disease? - Paul Hofman - Journal of thoracic disease (2019)
4. Demystifying the manipulation of host immunity, metabolism, and extraintestinal tumors by the gut microbiome. - Ziying Zhang;Haosheng Tang;Peng Chen;Hui Xie;Yongguang Tao - Signal transduction and targeted therapy (2019)
5. Serum IGFBP-1 as a potential biomarker for diagnosis of early-stage upper gastrointestinal tumour. - Yi-Wei Xu;Hao Chen;Chao-Qun Hong;Ling-Yu Chu;Shi-Han Yang;Li-Sheng Huang;Hong Guo;Liu-Yi Chen;Can-Tong Liu;Xin-Yi Huang;Lie-Hao Lin;Shu-Lin Chen;Zhi-Yong Wu;Yu-Hui Peng;Li-Yan Xu;En-Min Li - EBioMedicine (2020)
6. Identification of Circulating MicroRNAs as a Promising Diagnostic Biomarker for Cervical Intraepithelial Neoplasia and Early Cancer: A Meta-Analysis. - Yao Jiang;Zuohong Hu;Zhihua Zuo;Yiqin Li;Fei Pu;Biqiong Wang;Yan Tang;Yongcan Guo;Hualin Tao - BioMed research international (2020)
7. lncRNA STEAP3-AS1 Modulates Cell Cycle Progression via Affecting CDKN1C Expression through STEAP3 in Colon Cancer. - Heya Na;Xiaomeng Li;Xinsheng Zhang;Yue Xu;Yuzhu Sun;Jingyi Cui;Zihao Chen;Xiaomeng Shi;Shuangyi Ren;Yunfei Zuo - Molecular therapy. Nucleic acids (2020)
8. Target Analysis of Volatile Organic Compounds in Exhaled Breath for Lung Cancer Discrimination from Other Pulmonary Diseases and Healthy Persons. - Michalis Koureas;Paraskevi Kirgou;Grigoris Amoutzias;Christos Hadjichristodoulou;Konstantinos Gourgoulianis;Andreas Tsakalof - Metabolites (2020)
9. CD16 expression on neutrophils predicts treatment efficacy of capecitabine in colorectal cancer patients. - Yu Lu;Yizhou Huang;Lei Huang;Yanjie Xu;Zien Wang;Han Li;Ting Zhang;Ming Zhong;Wei-Qiang Gao;Yan Zhang - BMC immunology (2020)
10. Promise of Smartphone-Enabled Teleconsultation for Global Cancer Prevention. - Paul C Pearlman - JCO global oncology (2020)

... (39 more literatures)

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