Establishing Cancer Screening Recommendations for Major Cancers in Korea

The objective of cancer screening is to reduce the risk of death, i.e., mortality from cancer among individuals subjected to screening. For cervical and colorectal cancer, the screening test is aimed at detection of preinvasive lesions. Therefore, reduction in the incidence of invasive disease also results from screening.

In a national cancer control program, the programs should be orgainzed to ensure that a large proportion of the target group is screened and that those individuals in whom abnormalities are abserved receive appropriate diagnosis and therapy. Agreement should be reached on guidelines to be applied in the national cancer control program.

When establishing appropriate cancer screening recommendations several factors should be considered. ① For establishing the starting age, age-specific incidence and mortality rate, life lost person-years, and cost-effectiveness can be considered. ② For frequency of screening, it is necessary to understand the natural history of disease. ③ For choosing the best test tool, sensitivity and specificity, compliance, cost, and adverse effects can be considered.

It seems that doctors' willingness to participate is essential for a successful cancer screening program. They should understand the rationale of cancer secreening, its effectiveness, and the risk.