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Without such global guidelines or nation-wide screening programmes, it is all the more important to provide clear recommendations to patients. Some people are more at risk than others due to their clinical history or family background, and doc-tors can advise them on how to proceed to avoid any future complications. “People who have high risk factors, such as a family history of particular cancers and some related gene carriers, should be screened.” It is generally accepted that people aged over 55, with a smoking history of one pack per day over 30 years, and former smokers, who have quit within the last 15 years, should be screened for lung cancer. For women with a lifetime cancer risk of 20% or greater, for instance women with a genetic risk, a breast examination with magnetic resonance imaging (MRI) is recommended. People with liver cirrhosis and/or hepatitis B or C virus should be screened to detect any signs of liver cancer. People can obtain information about screening from their general practitioners, gynaecologists, urologists, and any other specialist, who should be able to advise when to screen and for what. Some patients may also benefit from their companies’ medical insurance, which in some countries may cover the annual health-check for their employees over a certain age. The success of screening depends entirely on how well-informed the public is and on the health policies of each country. “Providing the public with complete information is really a key issue for the success of a screening campaign. Having the patient as a partner makes everything easier.” Public awareness campaigns play a major role in this dialogue, and the participation of institutional partners is highly desirable. Healthcare stakeholders and cancer patient societies should be incorporated into these campaigns. Information is also key to improving public healthcare. The more informed the public is, the likelier they are to push their governments to take action.
Cancer screening undoubtedly brings benefits, when it leads to the identification of cancer before it poses a real danger and requires intensive and often expensive treatment. But one should also be aware of the risks that are associated with imaging examinations. Mammography, for instance, involves a small amount of ionising radiation, which can have a potentially carcinogenic effect.
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