To screen or not to screen?

A big part of the medical field is preventive medicine, a vital part of which is screening.

It is an undisputed fact that cancer screening is necessary. It enables early detection of cancer in individuals, which assures better prognosis and better survival rates.

Frequently used in medicine is the phrase “five-year survival rate”, which denotes the prognosis of a certain disease, like cancer, and indicates the percentage of patients who will be cancer free five years after the diagnosis, provided that they undergo the necessary treatment.

In the case of colon cancer, for example, the five-year survival for stage 1 colon cancer is 90 per cent, while that of stage 4 is only 10 per cent. 

That means that for every 100 patients diagnosed with stage 1 colon cancer and treated, 90 patients will be cancer free after five years, while only 10 out of a 100 will be cancer free in five years after the diagnosis with stage 4 colon cancer. A radical difference!

Theoretically, if everyone screens, deaths from cancer would dramatically decrease. The problem lies in people’s knowledge of and attitude towards cancer.

The study “Colorectal Cancer in Jordan: prevention and care”, published in 2014, examined individuals’ knowledge of colorectal cancer and their practices and attitudes towards its prevention and care. 

The study had 3,196 adult participants; of those, only 11 per cent reported ever screening for cancer, only 9.1 per cent reported ever screening for colon cancer and only 20 per cent knew that colon cancer screening tests exist.

On the other hand, a recent study in Europe, titled “Public awareness of risk factors and screening for colorectal cancer in Europe”, found that 51 per cent of Europeans have knowledge of colorectal cancer screening.

Another recent study, “Predictors of cancer awareness among older adult individuals in Jordan”, found that the major reason older adults (average age of study participants was 63) do not perform regular health check-ups is that they believe that having no health problem makes them feel safer and not at risk of getting cancer.

The study, “Cancer prevention and care: a national sample from Jordan”, found that women in Jordan are seven times more likely than men to screen for cancer, which proves the effectiveness of campaigns aimed at educating people on cancer screening.

There are national campaigns that urge women in Jordan to screen for breast cancer, yet no campaigns urging men to screen for diseases exist, nor are there campaigns urging screening for other types of cancer than breast cancer for women.

Thus, more efforts should be geared towards raising public awareness on the issue.

Currently, cancer is the second leading cause of death in Jordan. 

The treatment of many types of cancer has improved dramatically, but the earlier cancer is detected the easier it is to treat. Hence, a lot rides on screening in case of cancer.

Unfortunately, the necessity of cancer screening is not as clear to the public as one hopes. 

More efforts, therefore, should be geared towards running effective cancer screening campaigns in order to noticeably increase the percentage of those who actually step forward to screen.

Moreover, healthcare professionals, especially physicians, should be more involved in educating their patients on the benefits of cancer screening and addressing head on their fears, inhibitions and false assumptions.

The writer is an MD, intern at Al Hussein Salt Hospital. He contributed this article to The Jordan Times.