Cancer screening is a signal protocol created by health manpower to save lives due to prevention of cancer establishment or early detection with better prognosis. During the recent decade, some doubt have been casted and fact have risen to inhibit classic screening and introduce same new procedure instead of them.
The most popular cancer in screening procedures is breast cancer.
Obviously, mammography screening has saved many lives and has changed the clinical feature from locally advance to early stages. Comparing the trends of clinical staging of breast cancer before and after national screening program has confirmed this idea.In addition, recently, many researches have focused on the harm of mammography screening for example, the 2016, 352: bmj h 6967 reported that the harms of mammography screening outweigh its benefits.
The member of cancer who died from breast cancer and other malignancies are not significantly different but the number of false diagnosis, harmful treatment, and the member of over treatment from non-progressive malignancies are significantly higher in the screening group.
Here, I try to say something different about the benefits or harms of screening. Sometimes the definition of screening and its goal should be changed, for example in developing countries some kind of screening for breast cancer maybe efficient which are different from well- known mammography screening.
In Iran about 40% of breast cancer cases are locally advanced as metastatic. Many of these cases are related to primary tumor size.
Changing the community knowledge and health crew expertise will change this feature, and early stages with easier treatments and better prognosis will appear. Of course the subject of time will remain a challenging issue.
We will discuss more in the next issue.
