cancer screening guidelines

cancer screening guidelines

cancer screening guidelines - Cervical Cancer Screening: Primum Non Nocere, The Hippocratic Oath cautions us “to abstain from doing harm.” We must remember this basic tenet of our profession as we address new evidence and guidelines for cervical cancer screening. The purpose of screening is to identify at-risk individuals and to enable early intervention to reduce mortality and suffering. As such, screening should fit the ideal of doing no harm, yet providing substantial benefit.

 

However, screening tests can unintentionally cause significant harm. False-positive test results can lead to overdiagnosis; misdiagnosis; and the potential for unnecessary diagnostic testing, procedures, and treatments and their inherent risks. For these reasons, screening tests, especially for a disease with a low incidence, must have high sensitivity in addition to acceptable specificity. Tradeoffs of increased sensitivity for decreased specificity can shift the balance of benefits and harms.

 

It is important to consider these issues as one reads the U.S. Preventive Services Task Force (USPSTF) most current recommendations for cervical cancer screening in this issue. The American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology (ACS/ASCCP/ASCP) have also published new joint cervical cancer prevention guidelines based on a broadly attended consensus conference (1). These 2 sets of recommendations are largely congruent and are important steps forward to maximally efficient and effective cervical cancer screening. Health care providers should welcome these new recommendations with enthusiasm and incorporate them into routine clinical practice.