Screening for Cancer

  • John R. Feussner
  • Eugene Z. Oddone
  • Jeffrey G. Wong

Abstract

Early detection of disease, or screening, is an attractive diagnostic strategy for physicians. Screening facilitates detection of disease early in its clinical course, before many pathologic changes have occurred and while the disease may be more amenable to treatment. As attractive as early detection may seem, however, certain principles should be considered to assure the appropriateness of any decision to seek early diagnosis (Table 18.1).1 Such considerations include the importance or seriousness of the target disease; the presence of an early presymptomatic period; the accuracy and acceptability of available diagnostic tests; the risk associated with invasive diagnostic testing; the efficacy, cost, and availability of treatment; and the risk of treatment, such as adverse drug effects or adverse outcomes of surgery. The absence of clear information about any one of these considerations will diminish the potential value of any screening strategy.

Keywords

Breast Cancer Prostate Cancer Ovarian Cancer Cervical Cancer Cancer Screening 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Wilson JMG, Jungner G. Principles of early disease detection. World Health Organization Public Health Papers. 1968; 34: 27–39.Google Scholar
  2. 2.
    Sackett DL, Haynes RB, Guyatt GH, et al. Clinical Epidemiology: A Basic Science for Clinical Medicine. Boston: Little, Brown; 1991: 153–170.Google Scholar
  3. 3.
    Baranovsky A, Myers HG. Cancer incidence and survival in patients 65 years of age and older. CA. 1986; 36: 27–36.Google Scholar
  4. 4.
    Crawford J, Cohen HJ. Relationships of cancer and aging. Clin Geriatr Med. 1987; 4: 419–432.Google Scholar
  5. 5.
    Boring CC, Squires TS, Tong T, Montgomery S. Cancer statistics, 1994. CA. 1994; 44: 7–26.Google Scholar
  6. 6.
    Harris JR, Lippman ME, Veronesi U, et al. Breast cancer. N Engl J Med. 1992; 327: 319–328.PubMedCrossRefGoogle Scholar
  7. 7.
    Cancer Facts and Figures-1994. Atlanta: American Cancer Society; 1994.Google Scholar
  8. 8.
    O’Malley JS, Fletcher SW. Screening for breast cancer with breast self-examination. DAMA. 1987; 257: 2196.Google Scholar
  9. 9.
    Haughey BP, Marshal JR, Mettlin C, et al. Nurses’ ability to detect nodules in silicone breast models. Oncol Nurs Forum. 1984; 1: 37–42.Google Scholar
  10. 10.
    Fletcher SW, O’Malley MS, Bunce LA. Physicians’ abilities to detect lumps in silicone breast models. DAMA. 1985; 253: 2224–2228.Google Scholar
  11. 11.
    Baker LH, Chin TY, Wagner KV. Progress in screening for early cancer. J Surg Oncol. 1985; 30: 96.PubMedCrossRefGoogle Scholar
  12. 12.
    Baines CJ, McFarlane DV, Miller AB. Sensitivity and specificity of first screen mammography in 15 NBSS centres. Can Assoc Radiol J. 1988; 39: 273–276.PubMedGoogle Scholar
  13. 13.
    Verbeek AL, Hendricks JH, Holland R, et al. Reduction of breast cancer mortality through mass screening with modern mammography. First results of the Nijmegen project, 1975–1981. Lancet. 1984; 1: 1222–1224.PubMedCrossRefGoogle Scholar
  14. 14.
    Fletcher SW, Black W, Harris R, et al. Report of the International Workshop on Screening for Breast Cancer. J Natl Cancer Inst. 1993; 85: 1644–1656.PubMedCrossRefGoogle Scholar
  15. 15.
    Nystrom L, Rutqvist LE, Wall S, et al. Breast cancer screening with mammography: overview of Swedish randomized trials. Lancet. 1993; 341: 973–978.PubMedCrossRefGoogle Scholar
  16. 16.
    Shapiro S, Venet W, Strax P, et al. Ten to 14-year effect of screening on breast cancer mortality. J Natl Cancer Inst. 1982; 69: 349.PubMedGoogle Scholar
  17. 17.
    Mandelblatt JS, Wheat ME, Monane M, et al. Breast cancer screening for elderly women with and without comorbid conditions: a decision analysis model. Ann Intern Med. 1992; 116: 722–730.PubMedGoogle Scholar
  18. 18.
    American Cancer Society. 1989 survey of physician’s attitudes and practices in early cancer detection. CA. 1990; 40: 77.Google Scholar
  19. 20.
    Black JS, Sefcik T, Kapoor W. Health promotion and disease prevention in the elderly. Arch Intern Med. 1990; 150: 389.PubMedCrossRefGoogle Scholar
  20. 21.
    Schwartz JS, Lewis CE, Clancy C, et al. Internists’ practices in health promotion and disease prevention. Ann Intern Med. 1991; 114: 146.Google Scholar
  21. 22.
    Fink DJ. Guidelines for the Cancer-Related Checkup: Recommendations and Rationale. Atlanta: American Cancer Society; 1991.Google Scholar
  22. 23.
    U.S. Preventive Services Task Force. Fisher M, ed. Guide to Clinical Preventive Services. Baltimore: Williams and Wilkins; 1989.Google Scholar
  23. 24.
    Boyes, DA, Morrison B, Knox EG, et al. A cohort study of cervical cancer screening in British Columbia. Clin Invest Med. 1982; 5: 1–29.PubMedGoogle Scholar
  24. 25.
    Mandelblatt J, Gopal I, Wistreich M. Gynecological care of elderly women. JAMA. 1986; 256: 367–371.Google Scholar
  25. 26.
    Tawa K, Forsythe A, Cove JK, et al. A comparison of the Papanicolaou smear and the cervigram: sensitivity, specificity and cost analysis. Obstet Gynecol. 1988; 71: 229–235.PubMedGoogle Scholar
  26. 27.
    Fahs MC, Mandelblatt J, Schechter C, et al. Cost effectiveness of cervical cancer screening for the elderly. Ann Intern Med. 1992; 117: 520–527.PubMedGoogle Scholar
  27. 28.
    Richert-Boe KE, Humphrey LL Screening for cancers of the cervix and breast. Arch Intern Med. 1992; 152: 2405 2411.Google Scholar
  28. 29.
    Eddy DM. Screening for cervical cancer. Ann Intern Med. 1990; 113: 214–226.PubMedGoogle Scholar
  29. 30.
    Wright VC, Roipelle MA. Age at time of intercourse versus chronologie age as a basis for Pap smear screening. Can Med Assoc J. 1982; 127: 127–131.PubMedGoogle Scholar
  30. 31.
    Celentano DD, Klassen AC, Weisman CS, et al. Cervical cancer screening practices among older women. J Clin Epidemiol. 1988; 41: 531–541.PubMedCrossRefGoogle Scholar
  31. 32.
    Mandelblatt J, Traxler M, Lakin P, et al. A nurse practitio-ner intervention to increase breast and cervical cancer screening for poor, elderly black women. J Gen InternMed. 1993; 8: 173–178.Google Scholar
  32. Weintraub NT, Freedman ML. Gynecologic malignancies rescreening for colorectal cancer: a controlled trial of of the elderly. Clin Geriatr Med. 1987; 3: 669–694.Google Scholar
  33. 34.
    Yancik R, Gloeckler L, Yates J. Ovarian cancer in the elderly: an analysis of surveillance, epidemiology, and end results program data. Am J Obstet Gynecol. 1986; 154: 639–647.PubMedGoogle Scholar
  34. Carlson KJ, Skates SJ, Singer DE. Screening for ovarian cancer. Ann Intern Med. 1994; 121: 124–132.Google Scholar
  35. 36.
    van Nagell Jr Fr, DePriest PD, Gallion HH, et al. Ovarian cancer screening. Cancer. 1993; 71: 1523–1528.Google Scholar
  36. Schapira MM, Matchar DB, Young MJ. The effectiveness of ovarian cancer screening: a decision analysis model. Ann Intern Med. 1993: 118: 838–843.Google Scholar
  37. Bast RC Jr, Klug TL, St John E, et al. A radioimmunoas epithelial ovarian cancer. N Engl J Med. 1983; 309: 883–887.Google Scholar
  38. 39.
    Report of Task Force on Routine Cancer Screening.ACOG Committee Opinion No. 68. Washington, DC:American College of Obstetricians and Gynecologists;1989.Google Scholar
  39. 40.
    The American College of Physicians. Screening for ova-rian cancer: recommendations and rationale. Ann Intern Med. 1994; 121: 141–142.Google Scholar
  40. 41.
    Winawer SJ, Fath RB Jr, Schottenfeld D, et al. Screening for cancer. In: Miller AB, ed. Screening for Cancer. NewYork: Academic Press; 1985.Google Scholar
  41. 42.
    Muto T, Bussey HJR, Morson BC. The evolution of can cer of the colon and rectum. Cancer. 1975; 36: 2251–2270.PubMedCrossRefGoogle Scholar
  42. 43.
    Surveillance, Epidemiology and End Results: IncidenceMonograph No. 57. Bethesda, MD: NCI; 1981.Google Scholar
  43. 44.
    Schottenfeld D, Winawer SJ. Large intestine. In:vention, Epidemilogy, and Screening. New York: RavenPress; 1980: 175–180.Google Scholar
  44. 45.
    Crowley ML, Freeman LD, Mottet MD, et al. Sensitivity of guaiac-impregnated cards for the detection of colorectal neoplasia. J Clin Gastroenterol. 1983; 5: 127–130.PubMedCrossRefGoogle Scholar
  45. Macrae FA, St. John DJB. Relationship between patterns colorectal cancers or adenomas. Gastroenterology. 1982; 82:891–898.Google Scholar
  46. 47.
    Flehinger BJ, Herbert E, Winawer SJ, et al. Screening for colorectal cancer with fecal occult blood test and Clinic. In: Chamberlain J, Miller AB, eds. Screening for Gastrointestinal Cancer. Toronto: Hans Huber; 1988: 9–16.Google Scholar
  47. 48.
    Hardcastle JD, Thomas WM, Chamberlain J, et al. Ran-domized controlled trial of fecal occult blood screening for colorectal cancer: the results of the first 107,349 subjects.Lancet. 1989; 1: 1160–1164.Google Scholar
  48. 49.
    Mandel JS, Bond JH, Church TR, et al. Reducing mortal- ity from colorectal cancer by screening for fecal occultblood. N Engl J Med. 1993; 328: 1365–1371.PubMedCrossRefGoogle Scholar
  49. 50.
    Kronborg O, Fenger C, et al. Initial mass screening for colorectal cancer with fecal occult blood test. Scand JGastroenterol. 1987; 22: 677–686.CrossRefGoogle Scholar
  50. 51.
    Kewenter J, Bjork S, Haglind E, et al. Screening and fecal occult blood testing in 27,000 subjects. Cancer. 1988; 62: 645–651.PubMedCrossRefGoogle Scholar
  51. 52.
    Selby JV, Friedman GD, Quesenberry CP, et al. A case-control study of screening sigmoidoscopy and mortality from colorectal cancer. N Engl J Med. 1992; 326: 653–657.PubMedCrossRefGoogle Scholar
  52. 53.
    Carter HB, Coffey DS. The prostate: an increasing medi-cal problem. Prostate. 1990; 16: 39–48.PubMedCrossRefGoogle Scholar
  53. 54.
    Stamey TA, Freiha FS, McNeal JE, et al. Localized pros-tate cancer: relationship of tumor volume to clinical sig-nificance of prostate cancer. Cancer. 1993; 71: 933–938.PubMedCrossRefGoogle Scholar
  54. 55.
    Cannon L, Bishop DT, Skolnick M, et al. Genetic epidemi-ology of prostate cancer in the Utah Mormon genealogy.Cancer Surv. 1982; 1: 47–69.Google Scholar
  55. 56.
    Boring CC, Squires TS, Heath CW Jr. Cancer statistics of African Americans. CA. 1992; 42: 7–18.Google Scholar
  56. 57.
    Meikle AW, Smith JA. Epidemiology of prostate cancer. Urol Clin North Am. 1990; 17: 709–718.PubMedGoogle Scholar
  57. 58.
    Pienta KJ, Esper PS. Risk factors of prostate cancer. AnnIntern Med. 1993; 118: 793–803.Google Scholar
  58. 59.
    Johansson, JE, Adami HO, Andersson SO, et al. High 10-year survival rate in patients with early, untreated prostatecancer. DAMA. 1992; 267: 2191–2196.CrossRefGoogle Scholar
  59. 60.
    Resnick MI, Bagshaw MA, Door FA, et al. Response progression criteria for evaluating prostate cancer.In: Coffey DS, Resnick MI, Door FA, Karr JP, eds. AMultidisciplinary Analysis of Controversies in the Manage-ment of Prostate Cancer. New York: Plenum Press; 1988: 299–308.Google Scholar
  60. 61.
    Chodak GW, Keller P, Schoenberg H. Routine screening for prostate cancer using digital rectal examination. Prog Clin Biol Res. 1988; 269: 87–98.PubMedGoogle Scholar
  61. 62.
    Johansson JE, Adami HO, Andersson SO, et al. Natural history of localized prostate cancer. A population-based study in 223 untreated patients. Lancet. 1989; 1: 799–803.PubMedCrossRefGoogle Scholar
  62. 63.
    Spigelman SS, McNeal JE, Freiha FS, et al. Rectal exami-nation in volume determination of carcinoma of the pros-tate: clinical and anatomical correlations. J Urol. 1986; 136: 1228–1230.PubMedGoogle Scholar
  63. 64.
    Vihko P, Kontturi O, Ervast J, et al. Screening for carci-noma of the prostate: rectal examination and enzymatic radioimmunologic measurements of serum acid phos-phatase compared. Cancer. 1985; 56: 173–177.PubMedCrossRefGoogle Scholar
  64. 65.
    Stamey TA. Cancer of the prostate. Monogr Urol.sigmoidscopy: preliminary report of the colon project of1983;4:65–132.Google Scholar
  65. 66.
    Chodak GW, Wald V, Parmer E, et al. Comparison of digital examination and transrectal untrasonography for the diagnosis of prostatic cancer. J Urol. 1986; 135: 951–994.PubMedGoogle Scholar
  66. 67.
    Mettlin C, Lee F, Drago J, et al. The American Cancer Society National Prostate Cancer Detection Project. Find-ings on the detection of early prostate cancer in 2425 men. Cancer. 1991; 67: 2949–2958.Google Scholar
  67. 68.
    Catalona WJ, Smith DS, Ratliff TL, et al. Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. N Engl J Med. 1991; 324: 1156–1161.PubMedCrossRefGoogle Scholar
  68. 69.
    Ritchie JP, Catalona WJ, Ahmann FR, et al. Effect of age on early detection of prostate cancer with serum prostate-specific antigen and digital rectal examination. Urology. 1993; 42: 365–374.CrossRefGoogle Scholar
  69. 70.
    Benson MC, Whang IS, Pantuck A, et al. Prostate specific antigen density: a means of distinguishing benign prostatic hypertrophy and prostate cancer. J Urol. 1992; 147: 815816.Google Scholar
  70. 71.
    Benson MC, Whang IS, Olsson CA, et al. The use of prostate specific antigen density to enhance the predictive value of intermediate levels of serum prostate specific antigen. J Urol. 1992; 147: 817–821.PubMedGoogle Scholar
  71. 72.
    Benson MC, McMahon DJ, Cooner WH, et al. An algorithm for prostate cancer detection in a patient population using prostate-specific antigen and prostate-specific antigen density. World J Urol. 1993; 11: 206–213.PubMedCrossRefGoogle Scholar
  72. 73.
    Brawer MK, Aramburu EAG, Chen GL, et al. The inability of prostate specific antigen index to enhance the predictive value of prostate specific antigen in the diagnosis of prostatic carcinoma. J Urol. 1993; 150: 3693–3673.Google Scholar
  73. 74.
    Lookner DH, Crawford ED, Donohue RE, et al. Prostate specific antigen and prostate specific antigen density in cases of pathologically proven prostate cancer. J Urol. 1993; 149: 414A.Google Scholar
  74. 75.
    Carter HG, Pearson, JD, Metter EJ, et al. Longitudinal evaluation of prostate-specific antigen levels in men with and without prostate disease. JAMA. 1992; 267: 2215 2220.Google Scholar
  75. 76.
    Riehmann M, Rhodes PR, Cook TD, et al. Analysis of variation in prostate specific antigen values. Urology. 1993; 42: 390–397.PubMedCrossRefGoogle Scholar
  76. 77.
    Lilja H, Crocket AT, Abrahamsson PA. Prostate specific antigen predominatly forms a complex with alpha 1antichymotypsin in blood. Implications for procedures to measure prostate specific antigen in serum. Cancer. 1992; 70: 230–234.PubMedCrossRefGoogle Scholar
  77. 78.
    The Surgeon General’s 1989 report on reducing the health consequences of smoking: 25 years of progress. MMWR. 1989;38(suppl 2):1–32.Google Scholar
  78. 79.
    Hammond EC, Selikoff IJ, Seidman H. Asbestos exposure, cigarette smoking and death rates. Ann NY Acad Sci. 1979; 330: 473–490.PubMedCrossRefGoogle Scholar
  79. 80.
    Roscoe RJ, Steenland K, Halperin WE, et al. Lung cancer mortality among nonsmoking uranium miners exposed to radon daughters. JAMA. 1989; 262: 629–633.Google Scholar
  80. 81.
    Flehinger BJ, Kimmel M, Melamed MR. The effect of surgical treatment on the survival from early lung cancer: implications for screening. Chest. 1992; 101: 1013–1038.PubMedCrossRefGoogle Scholar
  81. 82.
    Flehinger BJ, Kimmel M. Natural history of adenocarcinoma-large cell carcinoma of lung: conclusions from screening programs in New York and Baltimore. J Nall Cancer Inst. 1988; 80: 337–344.CrossRefGoogle Scholar
  82. 83.
    Herman PG, Gerson DE, Hessel SJ, et al. Disagreements in chest roentgen interpretation. Chest. 1975; 68: 278–282.PubMedCrossRefGoogle Scholar
  83. 84.
    Melemed MR, Flehinger BJ, Zaman MB, et al. Screening for early lung cancer: results of the Memorial Sloan-Kettering study in New York. Chest. 1984; 86: 44–53.CrossRefGoogle Scholar
  84. 85.
    Tockman MS. Survival and mortality from lung cancer in a screened population: The Johns Hopkins study. Chest. 1986; 89: 324S - 325S.Google Scholar
  85. 86.
    Fontana RS, Sanderson DR, Woolner LS, et al. Screening for lung cancer: a critique of the Mayo Lung Project. Cancer. 1991; 67: 1155–1164.PubMedCrossRefGoogle Scholar
  86. 87.
    Kubik A, Parkin DM, Khlat M, et al. Lack of benefit from semi-annual screening for cancer of the lung: follow-up report of a randomized controlled trial on a population of high-risk males in Czechoslovakia. Im’ J Cancer. 1990; 45: 26–33.CrossRefGoogle Scholar
  87. 88.
    O’Rourke MA, Feussner JR, Feigel P, et al. Age trends of lung cancer stage at diagnosis: implications for lung cancer screening in the elderly. JAMA. 1987; 258: 921–926.Google Scholar
  88. 89.
    Pollack SV. Skin cancer in the elderly. Clin Geriatr Med. 1987; 3: 715–728.PubMedGoogle Scholar
  89. 90.
    Friedman RJ, Rigel DS, Silverman MK, et al. Malignant melanoma in the 1990s: the continued importance of early detection and the role of physician examination and self-examination of the skin. CA. 1991; 41: 201–226.Google Scholar
  90. 91.
    Weinstock MA, Bogaars HA, Ashley M, et al. Nonmelanoma skin cancer mortality. JAMA. 1991; 127: 1194 1197.Google Scholar
  91. 92.
    Albert VA, Koh HK, Geller AC, et al. Years of potential life lost: another indicator of the impact of cutaneous malignant melanoma on society. J Am Acad Dermatol. 1990; 23: 308–310.PubMedCrossRefGoogle Scholar
  92. 93.
    Karagas MR, Stukel TA, Greenberg ER, et al. Risk of subsequent basal cell carcinoma and squamous cell carcinoma of the skin among patients with prior skin cancer. JAMA. 1992; 267: 3305–3310.Google Scholar
  93. 94.
    Urback R. Incidence of nonmelanoma skin cancer. Dermatol Clin. 1991; 9: 751–755.Google Scholar
  94. 95.
    Rigel DS. Epidemiology and prognosis of melanoma. Ann Plast Surg. 1992; 28: 7–8.PubMedCrossRefGoogle Scholar
  95. 96.
    Committee on Guidelines of Care, American Academy of Dermatology. Guidelines of care for basal cell carcinoma. J Am Acad Dermatol. 1992; 26: 117–120.CrossRefGoogle Scholar
  96. 97.
    Austoker J. Melanoma: prevention and early diagnosis. Br Med J. 1994; 308: 1682–1686.CrossRefGoogle Scholar
  97. 98.
    Green A, Leslie D, Weedon D. Diagnosis of skin cancer in the general population. Med J Aust. 1988; 148: 447.PubMedGoogle Scholar
  98. 99.
    Presser SE, Tailor FR. Clinical diagnostic accuracy of basal cell carcinoma. J Am Acad Dermatol. 1987; 16: 988.PubMedCrossRefGoogle Scholar
  99. 100.
    Koh HK, Caruso A, Gage I, et al. Evaluation of melanoma skin cancer screening in Massachusetts. Cancer. 1990; 65: 375–379.PubMedCrossRefGoogle Scholar
  100. 101.
    Grin CM, Kipf AW, Welkovich B, et al. Accuracy in the clinical diagnosis of malignant melanoma. Arch Dermatol. 1990; 126: 763–766.PubMedCrossRefGoogle Scholar
  101. 102.
    Koh HK. Cutaneous melanoma. N Engl J Med. 1991; 325; 171–182.PubMedCrossRefGoogle Scholar
  102. 103.
    Working Guidelines for Early Cancer Detection: Rationale and Supporting Evidence to Decrease Mortality. Bethesda,MD: National Cancer Institute; 1987.Google Scholar
  103. 104.
    Canadian Task Force on the Periodic Health Examination. The periodic health examination: 2.1984 update. Can Med Assoc J. 1984; 130: 2–16.Google Scholar
  104. 105.
    Fedele DJ, Jones JA, Niessen LC. Oral cancer screening in the elderly. J Am Geriatr Soc. 1991; 39: 920–925.PubMedGoogle Scholar
  105. 106.
    Silverman S. Precancerous lesions and oral cancer in the elderly. Clin Geriatr Med. 1992; 8: 529–541.PubMedGoogle Scholar
  106. 107.
    Blitzer PH. Epidemiology of head and neck cancer. Semin Oncol. 1988; 15: 2–9.PubMedGoogle Scholar
  107. 108.
    Jacobs C. The internist in the management of head and neck cancer. Ann Intern Med. 1990; 113: 1771–1778.Google Scholar
  108. 109.
    Mashberg A, Meyers H. Anatomical site and size of 222 early asymptomatic oral squamous carcinomas. Cancer. 1976; 37: 2149–2157.PubMedCrossRefGoogle Scholar
  109. 110.
    Elwood JM, Gallagher RP. Factors influencing early diagnosis of cancer of the oral cavity. Can Med Assoc J. 1985; 133: 651–656.Google Scholar
  110. 111.
    Centers for Disease Control. Examinations for oral cancer—United States, 1992. MMWR. 1994; 43: 198200.Google Scholar
  111. 112.
    Mashberg A, Samit AM. Early detection, diagnosis, and management of oral and oropharyngeal cancer. CA. 1989; 39: 67–88.Google Scholar

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© Springer Science+Business Media New York 1997

Authors and Affiliations

  • John R. Feussner
  • Eugene Z. Oddone
  • Jeffrey G. Wong

There are no affiliations available

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