Abstract
Cancers of the uterine cervix, breast, lung and stomach are four of the most common cancers in Nepal. Lack of knowledge and awareness about cancer, its risk factors and negligence of the early warning signs play crucial role in raising the incidence of the cancer. Curative therapies are most successful when cancer is diagnosed and treated at an early stage.Organized cancer screening programmes provide screening to target population and use multidisciplinary delivery teams, coordinated clinical oversight committees, and regular review by a multidisciplinary evaluation board. For population-based screening programs, decision- making and governance structures, tasks and procedures need to be defined.In this paper, we review population-based cancer screening programmes of different countries and share recommendations and relevant evidence for screening and early detection of common cancers in Nepal. The evidence-based recommendations provided in this Review are intended to act as a guide for policy makers, clinicians, and public health practitioners who are developing and implementing strategies in cancer control. We also discuss the role of liquid biopsy in early detection, diagnosis and monitoring of cancers using circulating biomarkers. Despite challenges, time has come to include cell free circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs), as a parameters for early detection of cancer in the days to come.
Highlights
Cancer is a molecular disease associated with alterations in the genome
Annual screening in adults who: l currently smoke or have quit within the past 15 years; and l have at least a 30 pack-year smoking history; and l receive evidence- based smoking cessation counseling, if they are current smokers; and l have undergone a process of informed/shared decision making that included in formation about the potential benefits, limitations, and harms of screening with low-dose
Annual screening mammography and magnetic resonance imaging (MRI) starting at age 30 years are recommended for women with a known BRCA mutation, women who are untested but have a first-degree relative with a BRCA mutation, or women with an approximately 20% to 25% or greater lifetime risk of breast cancer based upon specialized breast cancer risk-estimation models capable of pedigree analysis of first-degree and second-degree relatives on both the maternal and paternal sides
Summary
Cancer is a molecular disease associated with alterations in the genome. Early diagnosis identifies symptomatic cancer cases at the earliest possible stage. The ACS recommends annual screening for lung cancer with LDCT in adults aged 55 to 74 years in relatively good health who:. Women who have had a total hysterectomy should stop cervical cancer screening Adults aged 45 years and older should undergo regular screening with either a high-sensitivity stool-based test or a structural (visual) exam, depending on patient preference and test availability. Annual screening in adults who: l currently smoke or have quit within the past 15 years; and l have at least a 30 pack-year smoking history; and l receive evidence- based smoking cessation counseling, if they are current smokers; and l have undergone a process of informed/shared decision making that included in formation about the potential benefits, limitations, and harms of screening with low-dose. Higher risk for CRC include: 1. Individuals with a history of adenomatous polyps
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