Analysis of International Experience in Organizing Screening Programs for Early Detection of Malignancies

Abstract

Screening and early diagnosis of cancer have been important components of the comprehensive measures to reduce the incidence and mortality of malignant neoplasms worldwide for quite some time. Despite the widespread use of oncological screening in different countries, doubts persist about its feasibility, methods used, or frequency of examinations. Several studies provide data that oncological screening programs do lead to a reduction in mortality from cancer, but do not reduce overall mortality. The American Society of Clinical Oncology continues to support oncological screening as an effective tool to reduce mortality from malignant neoplasms, but acknowledges that not all individuals who undergo screening will benefit from it, not all individuals with established malignant neoplasms will be cured, and undergoing screening today is not a guarantee of protection against cancer in the future. It is important to note that approaches to screening for malignant neoplasms are dynamically revised as new scientifically substantiated data emerge, and the interpretation by leading groups of experts may differ even within one country. This scientific article presents methods for evaluating the effectiveness of screening programs implementation, such as sensitivity and specificity, ROC analysis, positive and negative predictive value of screening, and results of randomized studies. A brief overview of the main international principles of implementing screening programs and recommendations of international medical communities is provided.