PerspectivePUBLIC HEALTH

Improving cancer screening programs

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Science  10 Jan 2020:
Vol. 367, Issue 6474, pp. 143-144
DOI: 10.1126/science.aay3156

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Summary

National cancer screening programs, such as mammography for breast cancer, are widely implemented to reduce cancer incidence and mortality in high-income countries. Their introduction is also being considered in low- and middle-income countries. For many cancer types, the benefits and harms of different screening tests and the intervals at which they should be implemented are unknown. Thus, randomized comparison testing is warranted. However, this is not possible because most people in high-income countries have already undergone screening or have refused screening and are not comparable (1). There is an ethical, medical, economic, and societal imperative for continuous evaluation of cancer screening programs to ensure that their benefits outweigh any harms. This may be achievable if the screening programs can become the arena for clinical testing through the implementation of learning screening programs.

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