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Of the various tools available, those that use x-ray technology, such as mammography for breast cancer screening, are standard examinations. Recently, multidetector computed tomography (CT), a computerised imaging tool which is used to create 3D images based on x-rays, has shown its strength in applications such as colorectal cancer screening. Multidetector CT is now being used much more frequently in the detection of pre-mography screening has helped reduce breast cancer mortality by 30%, according to a recent study, which was conducted over almost three decades. A recent National Lung Screening Trial (NLST) in the United States showed a reduction of 20% in lung cancer mortality among heavy smokers who were screened with low-dose spiral CT versus those screened with traditional chest x-ray. Screening practices vary considerably from one country to another. While Korea offers screening on a national level for stomach, liver, colorectal, breast and uterine cervix cancer, the most common types in that country, China and South Africa, for example, do not yet have any established national screening programmes. Most countries in America and Europe operate screening programmes for breast and cervical cancer, and many of those who have not already launched nationwide programmes for colorectal cancer are planning to introduce them soon. Lung cancer is also under evaluation as a possible subject of screening in many countries. Setting up a national screening programme is a complex task, partly because it is difficult to define precise target groups with age limits, similar clinical histories, and various other characteristics. Guide-lines for screening are determined locally and based on the resources of healthcare systems, the health concerns of the population, and cultural attitudes and priorities. High rates of under-reported disease present another challenge in collecting clear and reliable figures, while restricted access to the latest technology remains a problem in many parts of the world. The absence of adequate tools for detecting early or pre-cancerous conditions is all the more alarming in poorer countries, where cancer inci-dence is expected to increase by as much as 90% by 2030, according to a recent study. “In most developing countries, access to screening is extremely limited or even non-existent. Given that cancer incidence is expected to rise dramatically in some of these countries in the coming decades, the global medical community should work together to define minimum screening recommendations for all countries and to provide the necessary resources – including equipment and training – for essential screening programmes.” The study ‘Global cancer transitions according to the Human Development Index (2008–2030): a population-based study’ was led by Dr. Freddie Bray of the International Agency for Research on Cancer (IARC) and published in The Lancet Oncology in June 2012.
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