Cancer screening

Screening is testing a group of people in the population for signs of a disease when treatment is still possible. Screening tests aim to find disease in the early stages before it causes symptoms. Tests are offered to people who may have an increased risk of a particular disease because of their age, gender or other factors.

Screening looks for early signs of disease
Cancer screening programs look for early signs of the disease or indications that a person is more likely to develop the disease in the future. In most cases, early detection of cancer increases the chances of successful treatment.

It’s important to remember that a screening test cannot diagnose cancer. To make a cancer diagnosis, further investigations are necessary to confirm the findings of a screening test.
Different types of screening programs
There are three different approaches to screening:

• Mass (population-based) screening – an entire population in a certain age group is tested: for example, cervical cancer screening.
• Selective screening – screening of selected groups of people in high-risk categories: for example, genetic screening of people with a strong family history of breast cancer.
• Opportunistic screening – screening tests offered to people who are being examined for other reasons, as part of a routine medical check-up; for example, genetic screening tests are available for people with an established family history of bowel, breast or skin cancers.

• The cancer is common with a high rate of morbidity (illness) and mortality (death).
• The test can detect the disease or condition in its early stages or pick up signs that the disease may develop later.
• The disease or condition can be treated and the treatment is more effective, affordable, safe or acceptable in the earlier stages.
• The screening test is acceptable, since people tend to avoid unpleasant or painful medical tests, especially if they don’t have any symptoms.
• The program, including follow-up treatment where required, must be available to the majority of the people in the group you want to test (known as the ‘target population’).
• The target population group can be contacted, from records kept in a central register, to undergo screening – for example, by letters sent in the mail.
• The program is cost effective.

• BreastScreen – aims to detect early signs of breast cancer in women aged 50–69 every two years. The screening test used is a mammogram (x-ray) of the breasts.
• National Cervical Screening Program – aims to detect changes in the cervix that may lead to cervical cancer in women aged 20–69 every two years. The screening test used is a Pap smear, where a tiny sample of cervical cells is taken.
• National Bowel Cancer Screening Program – checks for bowel cancer. This program currently only screens people aged 50, 55 or 65 years old. The screening test used is a faecal occult blood test (FOBT), which detects any traces of blood from a stool sample.

• Some people find some screening tests invasive, uncomfortable, unpleasant or embarrassing and may not want to participate in the program.
• A person may be afraid of medical tests or procedures and avoid screening altogether. Concerns or fears about a screening test can be discussed with a doctor. It may be helpful to take a family member or friend along for support and reassurance.
• The tests aren’t perfect. Every test carries a small risk of giving a ‘false negative’, which means that the test shows the person doesn’t have cancer when in fact they do.
• Every test also carries a small risk of giving a ‘false positive’, which means that the test concludes the person has cancer when they don’t. This can lead to unnecessary worry and invasive tests such as a biopsy. Some of these tests may carry a small but significant risk of side effects or complications.

• Not smoking
• Avoiding second-hand tobacco smoke (passive smoking)
• Being SunSmart
• Being physically active
• Maintaining a healthy body weight
• Avoiding or limiting alcohol
• Eating a healthy diet.

• Your doctor
• Cancer Council Victoria, Information and Support Service Tel. 131 120 www.cancervic.org.au
• PapScreen Victoria
• BreastScreen Victoria
• Department of Health and Ageing

• The aim of cancer screening is to find a disease or condition in its early stages, before it causes symptoms. The aim is to increase the chance of successful treatment.
• Population-based screening programs exist for three cancers – breast, cervical and bowel.
• If you have worrying symptoms, see your doctor as soon as possible.

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