Cancer screening

A person preparing for breast cancer screening by mammography
Microscope image of the cervical gland showing an area of high grade epithelial dysplasia.
A bowel polyp that can be identified by sigmoidoscopy. Some polyps will develop into cancers if not removed.

Cancer screening aims to detect cancer before symptoms appear.

- Cancer screening
A person preparing for breast cancer screening by mammography

12 related topics

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A coronal CT scan showing a malignant mesothelioma
Legend: → tumor ←, ✱ central pleural effusion, 1 & 3 lungs, 2 spine, 4 ribs, 5 aorta, 6 spleen, 7 & 8 kidneys, 9 liver

Cancer

Group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body.

Group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body.

A coronal CT scan showing a malignant mesothelioma
Legend: → tumor ←, ✱ central pleural effusion, 1 & 3 lungs, 2 spine, 4 ribs, 5 aorta, 6 spleen, 7 & 8 kidneys, 9 liver
Symptoms of cancer metastasis depend on the location of the tumor.
The GHS Hazard pictogram for carcinogenic substances
Share of cancer deaths attributed to tobacco in 2016.
The incidence of lung cancer is highly correlated with smoking.
Cancers are caused by a series of mutations. Each mutation alters the behavior of the cell somewhat.
The central role of DNA damage and epigenetic defects in DNA repair genes in carcinogenesis
Chest X-ray showing lung cancer in the left lung
Three measures of global cancer mortality from 1990 to 2017
Engraving with two views of a Dutch woman who had a tumor removed from her neck in 1689
University of Florida Cancer Hospital
CancerTreeMammal
An invasive ductal carcinoma of the breast (pale area at the center) surrounded by spikes of whitish scar tissue and yellow fatty tissue
An invasive colorectal carcinoma (top center) in a colectomy specimen
A squamous-cell carcinoma (the whitish tumor) near the bronchi in a lung specimen
A large invasive ductal carcinoma in a mastectomy specimen

Most cancers are initially recognized either because of the appearance of signs or symptoms or through screening.

A chest X-ray showing a tumor in the lung (marked by arrow)

Lung cancer

Malignant lung tumor characterized by uncontrolled cell growth in tissues of the lung.

Malignant lung tumor characterized by uncontrolled cell growth in tissues of the lung.

A chest X-ray showing a tumor in the lung (marked by arrow)
Relationship between cigarette consumption per person (blue) and male lung cancer rates (dark yellow) in the US over the century
Risk of death from lung cancer is strongly correlated with smoking.
CT scan showing a cancerous tumor in the left lung
Primary pulmonary sarcoma in an asymptomatic 72-year-old male
Pie chart showing incidences of NSCLCs as compared to SCLCs shown at right, with fractions of smokers versus nonsmokers shown for each type
Cross section of a human lung: The white area in the upper lobe is cancer; the black areas are discoloration due to smoking.
Pneumonectomy specimen containing a squamous-cell carcinoma, seen as a white area near the bronchi
Brachytherapy (internal radiotherapy) for lung cancer given via the airway
Monoclonal antibodies used in the treatment of NSCLC and their mechanism of action https://doi.org/10.3390/ph13110373
The main treatment arms of phase 3 clinical trials providing immunotherapy in the first line for patients with NSCLC https://doi.org/10.3390/ph13110373
Overall survival in NSCLC patients treated with protocols incorporating immunotherapy in the first line for advanced or metastatic disease. Nasser NJ, Gorenberg M, Agbarya A. Pharmaceuticals 2020, 13(11), 373;
Lung cancer, incidence, mortality, and survival, England 1971–2011
Stage IA and IB lung cancer
Stage IIA lung cancer
Stage IIB lung cancer
One option for stage IIB lung cancer, with T2b; but if tumor is within 2 cm of the carina, this is stage 3
Stage IIIA lung cancer
Stage IIIA lung cancer, if there is one feature from the list on each side
Stage IIIA lung cancer
Stage IIIB lung cancer
Stage IIIB lung cancer
Stage IV lung cancer

Cancer screening uses medical tests to detect disease in large groups of people who have no symptoms.

Cancer screening is most useful in detecting slowly progressing cancers but can cause overdiagnosis if very slow or non-progressive cancers are detected.

Overdiagnosis

Diagnosis of disease that will never cause symptoms or death during a patient's ordinarily expected lifetime and thus presents no practical threat regardless of being pathologic.

Diagnosis of disease that will never cause symptoms or death during a patient's ordinarily expected lifetime and thus presents no practical threat regardless of being pathologic.

Cancer screening is most useful in detecting slowly progressing cancers but can cause overdiagnosis if very slow or non-progressive cancers are detected.

Although overdiagnosis is potentially applicable to the diagnosis of any disease, the concept was first recognized and studied in cancer screening—the systematic evaluation of asymptomatic patients to detect early forms of cancer.

Location and appearance of two example colorectal tumors

Colorectal cancer

Development of cancer from the colon or rectum (parts of the large intestine).

Development of cancer from the colon or rectum (parts of the large intestine).

Location and appearance of two example colorectal tumors
Longitudinally opened freshly resected colon segment showing a cancer and four polyps. Plus a schematic diagram indicating a likely field defect (a region of tissue that precedes and predisposes to the development of cancer) in this colon segment. The diagram indicates sub-clones and sub-sub-clones that were precursors to the tumors.
Colon cancer with extensive metastases to the liver
Relative incidence of various histopathological types of colorectal cancer. The vast majority of colorectal cancers are adenocarcinomas.
Micrograph of colorectal adenocarcinoma, showing "dirty necrosis".
A diagram of a local resection of early stage colon cancer
A diagram of local surgery for rectal cancer
Colon and rectum cancer deaths per million persons in 2012

Screening is effective for preventing and decreasing deaths from colorectal cancer.

A coal miner completes a screening survey for coalworker's pneumoconiosis.

Screening (medicine)

Strategy used to look for as-yet-unrecognised conditions or risk markers.

Strategy used to look for as-yet-unrecognised conditions or risk markers.

A coal miner completes a screening survey for coalworker's pneumoconiosis.
A mobile clinic used to screen coal miners at risk of black lung disease
Lead time bias leads to longer perceived survival with screening, even if the course of the disease is not altered
Length time bias leads to better perceived survival with screening, even if the course of the disease is not altered.

Cancer screening

Transitional cell carcinoma of the bladder. The white in the bladder is contrast.

Bladder cancer

Any of several types of cancer arising from the tissues of the urinary bladder.

Any of several types of cancer arising from the tissues of the urinary bladder.

Transitional cell carcinoma of the bladder. The white in the bladder is contrast.
Location of bladder cancer
Bladder wall thickening due to cancer
Bladder tumor in FDG PET due to the high physiological FDG-concentration in the bladder, furosemide was supplied together with 200 MBq FDG. The uptake cranial to the lesion is a physiological uptake in the colon.
Histopathology of urothelial carcinoma of the urinary bladder. Transurethral biopsy. H&E stain
Diagram showing the T stages of bladder cancer
Stage N1 bladder cancer
Advanced bladder cancer (M1b)
Lymph nodes in the pelvis. Bladder cancer commonly spreads to obturator and internal iliac (not labelled)
Lymphatic drainage of the bladder (lateral view).Tumors on the superolateral bladder wall spread to external iliac lymph nodes
Flow chart of treatment
Drug treatment (chemotherapy) into the bladder(Intravesical)
Attenuated strain of M. bovis used in the treatment of bladder cancer
Surgical reconstruction (neobladder) of the bladder following removal.

As of 2019 there is insufficient evidence to determine if screening for bladder cancer in people without symptoms is effective or not.

A stomach ulcer that was diagnosed as cancer on biopsy and surgically removed

Stomach cancer

Cancer that develops from the lining of the stomach.

Cancer that develops from the lining of the stomach.

A stomach ulcer that was diagnosed as cancer on biopsy and surgically removed
Endoscopic image of linitis plastica, a type of stomach cancer where the entire stomach is invaded, leading to a leather bottle-like appearance with blood coming out of it
Endoscopic images of the stomach cancer in early stage. Its histology was poorly differentiated adenocarcinoma with signet ring cells. Left above: normal, right above: FICE, left low: acetate stained, right low: AIM stained
Sequence of 123-iodine human scintiscans after an intravenous injection: (from left) after 30 minutes, 20 hours, and 48 hours - a high and rapid concentration of radio-iodine is evident in gastric mucosa of the stomach, in salivary glands, oral mucosa, and the periencephalic and cerebrospinal fluid (left). In the thyroid gland, I-concentration is more progressive, also in the reservoir (from 1% after 30 minutes to 5.8% after 48 hours, of the total injected dose).
Stomach cancer types by relative incidence
T stages of stomach cancer
Stomach cancer metastasized to the lungs
Anatomy before Roux-en-y surgery to resect stomach cancer
Stomach cancer deaths per million persons in 2012
Poor to moderately differentiated adenocarcinoma of the stomach. H&E stain.
Gastric signet ring cell carcinoma. H&E stain.
Adenocarcinoma of the stomach and intestinal metaplasia. H&E stain.

Japan and South Korea, two countries that have high rates of the disease, screen for stomach cancer.

Diagram showing the position of the pancreas, behind the stomach (which is transparent in this schematic).

Pancreatic cancer

Pancreatic cancer arises when cells in the pancreas, a glandular organ behind the stomach, begin to multiply out of control and form a mass.

Pancreatic cancer arises when cells in the pancreas, a glandular organ behind the stomach, begin to multiply out of control and form a mass.

Diagram showing the position of the pancreas, behind the stomach (which is transparent in this schematic).
The pancreas has many functions, served by the endocrine cells in the islets of Langerhans and the exocrine acinar cells. Pancreatic cancer may arise from any of these and disrupt any of their functions.
Jaundice can be a symptom, due to biliary obstruction from a pancreatic tumor.
Cross-section of a human liver, at autopsy, showing many large pale tumor deposits, that are secondary tumors derived from pancreatic cancer
Micrograph of pancreatic ductal adenocarcinoma (the most common type of pancreatic cancer), H&E stain
Micrographs of normal pancreas, pancreatic intraepithelial neoplasia (precursors to pancreatic carcinoma) and pancreatic carcinoma. H&E stain
The head, body, and tail of the pancreas: The stomach is faded out in this image to show the entire pancreas, of which the body and tail lie behind the stomach, and the neck partially behind.
Axial CT image with IV contrast and added color: Cross lines towards top left surround a macrocystic adenocarcinoma of the pancreatic head.
Abdominal ultrasonography of pancreatic cancer (presumably adenocarcinoma), with a dilated pancreatic duct to the right.
Fine needle aspiration of well-differentiated pancreatic adenocarcinoma, showing a flat sheet with prominent honeycombing. The disorganization, nuclear overlapping, and lack of uniform nuclear spacing provides a clue that is this adenocarcinoma (as opposed to non-neoplastic duct epithelium).
Pancreatic cancer metastasized – stage M1
Parts of the body removed in Whipple's operation
How the pancreas and bowel are joined back together after a Whipple's operation
Deaths from pancreatic cancer per million persons in 2012
Stage T1 pancreatic cancer
Stage T2 pancreatic cancer
Stage T3 pancreatic cancer
Stage T4 pancreatic cancer
Pancreatic cancer in nearby lymph nodes – Stage N1

Screening the general population has not been found to be effective.

Mammography

Mammography

Process of using low-energy X-rays (usually around 30 kVp) to examine the human breast for diagnosis and screening.

Process of using low-energy X-rays (usually around 30 kVp) to examine the human breast for diagnosis and screening.

Mammography
Illustration of a mammogram
A mobile mammography unit in New Zealand
Normal (left) versus cancerous (right) mammography image

Digital mammography may be "spot view", for breast biopsy, or "full field" (FFDM) for screening.

Computed tomography (CT) scanner, the usually recommended screening technique

Lung cancer screening

Computed tomography (CT) scanner, the usually recommended screening technique
Calcified lung nodule seen on Low Dose Chest CT (circled)
Calcified lung nodule seen on Standard Dose Chest CT (circled)

Lung cancer screening refers to cancer screening strategies used to identify early lung cancers before they cause symptoms, at a point where they are more likely to be curable.