The objective of screening is to reduce the public health burden from the target disease. For cancer, this means primarily prevention of cancer screening deaths. For some cancer types, a premalignant lesion can be detected by screening and treated, so that incidence of invasive cancer can be reduced. Before adopting a cancer screening program as a health-system wide policy, valid evidence of screening effectiveness in decreasing cancer mortality must be available from large population studies, ideally randomized screening trials. In addition, a favorable balance of benefits and harms and acceptable cost-effectiveness must be shown. To be feasible, resources including funding, personnel and expertise as well as equipment must be available not only for testing but also diagnostic confirmation and treatment. After implementation, the effectiveness of a cancer screening program should be monitored and evaluated.
This is an update of Anssi Auvinen, Matti Hakama, Cancer Screening: Theory and Applications, Editor(s): Stella R. Quah, International Encyclopedia of Public Health (Second Edition), Academic Press, 2017, Pages 389–405, ISBN 9780128037089, https://doi.org/10.1016/B978-0-12-803678-5.00050-3.