Future of Screening

Many challenges lie ahead for cancer screening. Better detection methods are urgently needed, and molecular detection methods may surpass current techniques. At the same time, more effort is required to encourage adherence to proven cancer screening modalities. Adherence to screening is less than optimal for the entire major recommended screening techniques. With discovery of mutations in susceptibility genes that predispose to cancer, new challenges in cancer screening arise with the need for appropriate screening recommendations and programs for high-risk subgroups. Not only are those who have inherited mutations for cancer susceptibility at higher risk for developing some cancers, but, often the age at onset among such individuals is younger than age at onset in the general population. This creates challenges for those who recommend and promote screening regimens. The example of this disease. Moreover, there are no good population data on which to base guidelines. Further study is needed to establish efficacious screening protocols for those who are genetically predisposed to cancer.

Among the challenges of the future is how to evaluate new screening technologies in a world where large RCTs may be increasingly difficult to conduct. In screening, as in other areas of medicine and public health, the inclination to recommend screening tests on the basis of an intriguing and promising study must be balanced by a careful assessment of the evidence.