‘Cancer’ - a word so small yet so destructive. In fact, in 2017, in the UK alone there was an astonishing 4 million cases and 9.56 million deaths worldwide. An inevitable disease that just continues to increase in size. As the philosopher Desiderius Erasmus once said, ‘prevention is better than cure’ - this is most certainly the case with cancer.
Cancer survival rates are the highest they have ever been. A way to improve survival rates even further is for cancer to be diagnosed even earlier. And the NHS’ plan to do such suggests that 'by 2028, the proportion of cancers diagnosed at stages 1 and 2 will rise from around half now to three-quarters of cancer patients’. The plan includes to lower the threshold requirements for patients to be referred for a screening by their GP, and to maximize the variety of cancers that can be detected by screening [3]. Despite routine cancer screenings helping reduce the spread of cancer meaning it can be treated a lot easier and with a higher success rate, another vital factor to highlight is to emphasize the importance of such screenings, raising awareness to premature symptoms which will thus encourage people to go for a screening in the first place. Examples include the self-examination flow diagrams created by the NHS for women to check for abnormalities in their breasts. But cancer screenings need to be normalized- people should not be embarrassed, worried or ashamed to have an examination. I feel as if people see screening programmes as something to carry out only if symptoms are apparent, where this simply is not the case. Routine cancer screenings reduce the risks of developing later stages of cancer which are much more difficult to control and may potentially already be terminal at the time of screening.
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More than one third of all humans are diagnosed with cancer, and this number could be massively reduced if people were to take advantage of the screening programmes prescribed by the NHS. In the UK, the NHS currently run screening programmes for breast, bowel and cervical cancer as are the three most common cancers, furthermore have the highest survival rates when diagnosed at an early stage. All women between the ages of 50 and 71 are entitled to a breast screening every 3 years. The process involves a mammogram of the tissue within both breasts. Screening is crucial as it maximizes the chances of finding cancerous tissue within the breast at an early stage, meaning it is much easier to conquer. A flaw however would be the fact that screens are not always entirely accurate; false negatives are unlikely but never impossible. Unclear mammograms may lead to a second scan being needed; this could cause the patient to feel distressed and lead to psychological complications such as anxiety or the mental despair caused by over-thinking about the reasons behind needing a second scan, which could lead to depression. Furthermore, going to one mammogram and receiving a negative result does not mean that the patient will never develop breast cancer, and this emphasizes the need for follow-up screenings. And as a result, through breast cancer screenings alone and hence early detection, 1,300 lives are annually saved in the UK. Controversy around radiation within breast cancer screening is apparent however this is outweighed by the potential positive impact of saving lives and preventing the need of a mastectomy or chemotherapy - not only does this positively increase the self-esteem of the patient but is also economically impactful for the NHS. Chemotherapy costs the NHS approximately £1.4 billion each year, equating to £30,000 for one round of treatment. This means that for every mammogram that catches the cancerous tissue at a stage prior to needing chemotherapy, the NHS are saving an incredible £30,000.
There are some cancers such as pancreatic cancer that have no symptoms and thus cannot always be picked up during a screening - the pancreas being so deeply embedded in the body hinders the ability of detecting pancreatic cancer via a CT scan also. This cancer only can be detected via the screening process when it has already begun to press onto nearby organs and at this point has grown to the extent that it has reached an advanced stage and is much more difficult to treat if not terminal. In this example, screening programmes are not very useful when detecting cancers with similar properties like pancreatic and thus is not offered commonly. Despite there being no symptoms, pancreatic cancer falls into the category where individuals might be at increased risk of developing the disease due to family history and therefore is an example where genetic testing is needed. Correspondingly, the plan devised by the NHS also outlines the necessity of ‘risk stratified screening’ and to test family members of patients with cancer where their risk of developing cancer is higher than average. Genetic testing delves into any gene mutations that cause the presence of such disease, meaning a healthy person could have their genome sequenced and compared to a cancer patient, to determine whether they too have the mutation in their genes and thus have a raised likelihood of developing that particular cancer if such gene were to be expressed and uncontrollably replicated. There are a selection of studies open with regards to helping stop the spread of pancreatic cancer in the UK in particular, such as the European Registry of Hereditary Pancreatitis and Familial Pancreatic Cancer (EUROPAC), observing the genetic causes of pancreatic cancer with aims of developing a successful screening programme in the nearby future. EUROPAC focus particularly on families where pancreatic cancer is already present and carry out investigations such as blood tests to determine as to whether the case of pancreatic cancer within the family is/ will become hereditary. There is a CA19-9 tumour marker commonly found in patients with pancreatic cancer; if this is found in a healthy patient their risks of also developing such cancer increases. Whilst understanding that you have a higher risk of developing a particular cancer allows you to become more focused on your health and therefore make more informed health-orientated decisions, discovering a gene mutation can also become psychologically draining. Adding anxieties to a person’s everyday life may stop them from living a fulfilled life, and just because their likelihood of developing such disease is higher does not mean they will acquire it. It is extremely difficult when faced with the decision of investigating your probable chances as to whether cancer is likely within your family, which is why many avoid screening programmes completely. The increased risk indoctrinates people into believing they are already sick, and that life itself is simply not worth living if cancer is around the corner.
Although screening programmes are massively impactful in stunting the spread of cancer by catching it at an early stage, another important factor of which must be stimulated is the encouragement of living a healthy lifestyle in order to prevent cancer as a whole. Schemes implemented to discourage smoking and alcohol have been deemed to successfully decrease the number of cancers within the lungs and liver - in fact by just simply introducing plainly-packaged cigarettes, the number of smokers within the UK decreased by a significant 300,000. Cancer treatment approximately costs the NHS around £30,000 per patient, and in contrast screening programmes cost £150 per patient. Economically, cancer screening programmes are so much less detrimental to the NHS. Screening and prevention programmes offered. Impact of Covid and the fall in screenings. Covid-19 has negatively affected the nation in several ways. In relation to cancer screening programmes, attendance to such appointments has massively declined.
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