It is generally believed that with the early detection of cancer there comes a better chance for a cure. For this reason, considerable attention has been paid to the problem of cancer screening. A primary objective for any screening program is to maximize the preventative effect and minimize the expenditure.
Considerable research has been conducted on cancer modeling and screening (t!:21). Typically, these investigations examine the statistical aspects of screening. The data obtained are used to estimate the natural history of a particular disease and then used to decide if screening was of benefit.
A number of criteria should be met before a disease merits routine screening on a mass scale in asymptomatic individuals (k!:589). For one, the condition should be serious: it should have major consequences for the population as a whole. In addition, the disease should have a recognizable preclinical early stage. Lastly, treatment at that preclinical stage should also result in reduced mortality.
Many forms of cancer meet these criteria. Over a million new cases of cancer are diagnosed in the United States annually (n!:11). Moreover, it is estimated that nearly half of the people diagnosed eventually succumb to the disease. According to the American Cancer Society, cancer mortality could be reduced by a third if all physicians regularly used early detection measures.
One problem, however, is a lack of clear policy regarding this issue. In 1991, after two years of discussions, the National Cancer Institute, the American Cancer Society, and eleven national medical organizations agreed upon a set of "working guidelines" (n!:11).
The screening procedures for skin cancer, for example, encourage all individuals to thoroughly examine their skin on a regular basis (n!:11). In addition, primary care physicians are directed to examine patients' skin as part of their periodic health examinations.
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