Evaluation of Cancer Screening

• 1. General Principles of Cancer Screening.- Consideration of a Potential Screening Test.- Evaluating the Performance of a Test.- Evaluating the Effectiveness of Screening.- Mathematical Models of Screening.- Selection of High-Risk Groups for Screening.- Promotion of Early Diagnosis.- Ethical Issues.- Genetic Issues.- References.- 2. Screening for Cancer of the Cervix.- Epidemiology of Cervical Cancer.- The Natural History of Cervical Cancer.- The “Pap” Test.- Evidence for the Effectiveness of Screening.- The Effectiveness of Screening in the UK.- The Treatment of Screen-Detected Lesions.- Cost-Effectiveness of Cervical Screening.- Frequency of Cervical Screening.- Quality Control Issues.- Sensitivity of Screening.- Potential for Automation.- Alternative Tests.- Screening in Developing Countries.- The Role of HPV in Cervical Cancer.- References.- 3. Screening for Cancer of the Breast.- Epidemiology.- Aetiology.- Treatment, Survival and Prognosis of Breast Cancer.- Predisposing Factors.- The Rationale for Screening.- Screening Tests for Breast Cancer.- Effectiveness of Screening in Reducing Mortality.- Effectiveness of Screening Younger Women.- Effectiveness of Breast Self-Examination.- Disadvantages and Costs of Breast Screening.- Conclusions.- References.- 4. Screening for Colorectal Cancer.- Time Trend.- Geographical Variation.- Aetiology and Primary Prevention.- High-Risk Groups for Colorectal Cancer.- Natural History.- Prognosis of Colorectal Carcinomas.- Overall Survival.- The Rationale for Screening.- Screening Methods.- The Acceptability of Screening.- The Effectiveness of Screening.- Disadvantages and Costs.- Conclusions.- References.- 5. Early Detection of Malignant Melanoma of the Skin.- Natural History.- The Screening Test for Malignant Melanoma.- Optionsfor Screening.- Health Education to Promote Self-Screening.- Organised Professional Screening.- Other Aspects of Screening.- Conclusions.- References.- 6. Screening for Ovarian Cancer.- General Requirements.- Candidate Tests: Evidence from Observational Studies.- Tumour Markers.- Improving Performance.- Intervention Studies.- Conclusions.- References.- 7. Screening for Prostate Cancer.- Time Trends and International Differences in Incidence.- Aetiology.- Staging.- Survival.- Natural History.- Determinants of Prognosis.- Screening Tests for Prostate Cancer.- Prevalence of Prostate Cancer at Screening.- Acceptability of Screening.- The Effect of Screening on Prostate Cancer Mortality.- The Potential Disadvantages of Screening for Prostate Cancer.- Conclusions.- References.- 8. Screening for Cancers of other Sites: Lung, Stomach, Oral and Neuroblastoma.- Lung Cancer.- Stomach.- Neuroblastoma.- Oral Cancer.- References.- 9. Psychological Aspects of Cancer Screening.- Research Methodology.- Psychological Effects of Invitation to Screening.- Psychological Effects of a Positive Screening Test.- Psychological Effects in Patients with Screen-Detected Cancer.- Reducing Distress — Improving Attendance.- Reduction in the Distress Caused by Recall.- Staff Stress.- Self-Screening ..- Selective Screening.- Conclusions and Further Research Needs.- References.- 10. Economic Aspects of Cancer Screening.- The Need for Economic Appraisal.- Methods for Economic Evaluation.- Economic Appraisal of Cancer Screening Programmes.- Some Empirical Findings of Economic Evaluations of Ca.- Screening.- Conclusions.- References.

"...a thorough and high quality review...I am delighted that this book has found its way onto my shelves." - Cancer Forum "This book is a good starting point for anybody who wishes to understand the pros and cons of introducing a given screening programme." Int. Journal of Epidemiology