Screening

Screening

Screening advances that lead to early detection have been a major contributor to better survival. Some advances in this area include routine mammography for breast cancer; colonoscopy and fecal occult blood testing for colon cancer; and Pap smears for cervical and endometrial cancers. With colon and cervical cancer screening, doctors can often identify and remove pre-cancerous lesions toprevent cancer from developing.

Recently, a major clinical trial showed that CT scanning can reduce the risk of lung cancer in heavy smokers by catching more cases early. Research is also under way to develop effective screening approaches for ovarian, pancreatic, kidney, and other cancers. 
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1999

DNA test approved to detect HPV virus, the virus that causes cervical cancer

DNA test approved to detect HPV virus, the virus that causes cervical cancer

The FDA approves a new test to detect the strains of the human papillomavirus (HPV) that are known to cause cervical cancer. The test, which identifies DNA from these high-risk virus types, is approved for use in women age 30 and older in combination with the Pap test, and for women of all ages who have an abnormal Pap test result. Subsequent studies show that HPV testing alone is significantly more sensitive at detecting advanced pre-cancers than the Pap test (96 percent vs. 55 percent), but HPV testing results in more false positive results. When combined, the HPV test and Pap tests are found to be 100 percent sensitive for identifying women at risk for cervical cancer. For women younger than age 30, however, the Pap test alone is sufficient and combined screening is not recommended.

More Information: 

Cancer.Net; Cervical Cancer: Screening and Prevention
N Engl J Med 2007; 357: 1579-1588
Widespread screening reduces cases of advanced cervical cancer in older women

Widespread screening reduces cases of advanced cervical cancer in older women

A study shows that Medicare coverage for cervical cancer screening in women over age 65 led to a 19 percent reduction in cervical cancer diagnoses in this group since 1990, enabling detection of more lesions in their precancerous stages, before they progressed to cancer. Current screening guidelines state that screening can be safely stopped in women over age 65 or 70 who have had three or more consecutive normal Pap test results and who have not had an abnormal screening result within the past 10 years.

More Information: 

Lancet 1990; 335(8681): 97–99
Obstetrics & Gynecology 2002; 100(1): 79–86

1998

New liquid-based Pap tests introduced

New liquid-based Pap tests introduced

FDA approves two new liquid-based Pap tests. Whereas conventional tests involve smearing a swab of cervical cells on a slide, in the new tests, the swab is placed into a special preservative solution. These liquid tests provide a clearer, easier-to-read sample for pathologists to review under a microscope, compared to the traditional method.

More Information: 

Cancer.Net; Pap Test

1990

U.S. government funds cervical cancer screenings for underserved women

U.S. government funds cervical cancer screenings for underserved women

Badge indicating that research was paid for using federal funds

The Breast and Cervical Cancer Mortality Prevention Act of 1990 provides access to free or low-cost breast and cervical cancer screenings to underserved women across the country. Since its inception, this program run by the U.S. Centers for Disease Control and Prevention has provided more than 9.2 million breast and cervical cancer screening examinations, and helped diagnose more than 2,554 cases of cervical cancer and 123,563 cervical "pre-cancers."

More Information: 

CDC Website: National Breast and Cervical Cancer Early Detection Program

1988

Standard system established for evaluating Pap test results

1986

FDA approves PSA test for prostate cancer screening

FDA approves PSA test for prostate cancer screening

Badge indicating that research was paid for using federal funds

The FDA approves the first PSA (prostate-specific antigen) test to screen for prostate cancer in men aged 50 and older. PSA is a protein produced by cells in the prostate gland, and is often elevated in men with prostate cancer. Widespread use of PSA testing leads to a significant jump in early-stage prostate cancer diagnoses, sparking a debate that continues today about whether such screening improves survival or simply leads to over-diagnosis and treatment of cancers that would never have become life-threatening.

More Information: 

J Urol. 1992; 147(3): 931-34

1980

New tools enable detection of early-stage prostate cancer

New tools enable detection of early-stage prostate cancer

Badge indicating that research was paid for using federal funds

Doctors begin using prostate ultrasound – in which sound waves are used to generate an image of the prostate – to detect abnormalities that may signal cancer. Together with a type of biopsy, in which a thin, hollow needle is used to extract prostate tissue for testing, doctors are far more able to detect the earliest stages of prostate cancer.

More Information: 

British Journal of Urology Intl 2011; 107(12): 1899–1905
Journal of Urology; 157(3): 902–06

1977

Growing use of mammography saves lives

Growing use of mammography saves lives

Regular breast cancer screening with mammography becomes increasingly common, helping to detect cancers at an earlier, more treatable stage. By the mid-1980s, nearly one-third of U.S. women over age 40 are screened. By 2008, the proportion screened approaches 70 percent. High screening rates – and resulting early detection – have contributed to a 27 percent reduction in breast cancer mortality among U.S. women since 1975.

More Information: 

Cancer.Net; Mammography
CDC Report: Health, United States, 2009

1971

Early prostate cancer screening regimen introduced

Early prostate cancer screening regimen introduced

Studies show that screening with annual rectal exams, followed by surgery to remove the prostate in men who are found to have cancer, enables men with the disease to live as long, on average, as those without cancer. However, such treatment comes at the expense of urinary continence and sexual function.

More Information: 

JAMA 1971; 215(1): 81-84
Screening tests for colorectal cancer dramatically reduce deaths

Screening tests for colorectal cancer dramatically reduce deaths

In 1967, the guaiac fecal occult blood test (FOBT) is introduced as a screening test for colorectal cancer, one of the most common forms of cancer. This simple and inexpensive tool detects the presence of blood in stool, a sign that cancerous or precancerous growths (called polyps) may be present. Within the next few years, two new screening techniques – flexible sigmoidoscopy and colonoscopy – enable physicians to examine the colon using a small camera attached to a flexible lighted tube. The widespread use of these approaches leads to better detection of precancerous polyps and early stage cancers that are usually curable with surgery. Over the coming decades, routine screening contributes to major reductions in colorectal cancer mortality – a total decline of more than 40 percent since 1975.

More Information: 

Cancer.Net; Colonoscopy
JAMA 1967; 201(12): 943-945
ASCO Guideline

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