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Challenges in the future of cancer screening

Lynge, Elsebeth ; Andersen, Berit ; Bojesen, Stig E. ; Petersen, Lone Kjeld ; Bech, Mickael ; Bøgsted, Martin ; Dam, Mie Seest ; Egstrand, Søren ; Hvass, Anne Mette Fløe and Kobylecki, Camilla J. , et al. (2025) In International Journal of Cancer
Abstract

The purpose of cancer screening is to reduce mortality, and ideally incidence, from the cancer screened for. Until recently, cancer screening has been offered to all persons in pre-defined sex- and age-groups. The exception is lung screening which is targeted to high-risk individuals. Evidence for effect of screening on cancer-specific mortality is available for cancer of the cervix, breast, colorectal, lung, and prostate, and on cancer-specific incidence for cervix and colorectal cancer. With more effective molecular and computational tools, the current paradigm of cancer screening will change. Manual reading of images and pathology in mammography, cytology, colposcopy, colonoscopy, and CT scan will be complemented or replaced by... (More)

The purpose of cancer screening is to reduce mortality, and ideally incidence, from the cancer screened for. Until recently, cancer screening has been offered to all persons in pre-defined sex- and age-groups. The exception is lung screening which is targeted to high-risk individuals. Evidence for effect of screening on cancer-specific mortality is available for cancer of the cervix, breast, colorectal, lung, and prostate, and on cancer-specific incidence for cervix and colorectal cancer. With more effective molecular and computational tools, the current paradigm of cancer screening will change. Manual reading of images and pathology in mammography, cytology, colposcopy, colonoscopy, and CT scan will be complemented or replaced by AI-interpretation. Risk stratification will diversify screening intensity, for instance in breast screening where modelling and randomized controlled trials are underway. Blood-based screening tests might allow for simultaneous early detection of several types of cancer. Furthermore, prediction models based on life trajectories in health and other data will enhance risk stratification, potentially dividing the population into groups with no need of screening, with need of simple or advanced screening, with need of surveillance or even diagnostics. In public health care systems, these developments must be closely monitored. Before replacing an existing program, evidence for non-inferiority in reducing cancer-specific mortality should be ensured. Benefits must outweigh harms, and citizens should have confidence in new screening schemes. With the pressure on health care resources, screening should continue in organized and monitored programs. Taking these conditions into account, the new screening tools will potentially enable improved cancer control.

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organization
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type
Contribution to journal
publication status
epub
subject
keywords
cancer, evidence, screening
in
International Journal of Cancer
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:41400247
  • scopus:105025420968
ISSN
0020-7136
DOI
10.1002/ijc.70286
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 The Author(s). International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.
id
31884594-84de-4e3e-897b-3238456cc4c4
date added to LUP
2026-01-05 08:35:53
date last changed
2026-01-05 10:37:51
@article{31884594-84de-4e3e-897b-3238456cc4c4,
  abstract     = {{<p>The purpose of cancer screening is to reduce mortality, and ideally incidence, from the cancer screened for. Until recently, cancer screening has been offered to all persons in pre-defined sex- and age-groups. The exception is lung screening which is targeted to high-risk individuals. Evidence for effect of screening on cancer-specific mortality is available for cancer of the cervix, breast, colorectal, lung, and prostate, and on cancer-specific incidence for cervix and colorectal cancer. With more effective molecular and computational tools, the current paradigm of cancer screening will change. Manual reading of images and pathology in mammography, cytology, colposcopy, colonoscopy, and CT scan will be complemented or replaced by AI-interpretation. Risk stratification will diversify screening intensity, for instance in breast screening where modelling and randomized controlled trials are underway. Blood-based screening tests might allow for simultaneous early detection of several types of cancer. Furthermore, prediction models based on life trajectories in health and other data will enhance risk stratification, potentially dividing the population into groups with no need of screening, with need of simple or advanced screening, with need of surveillance or even diagnostics. In public health care systems, these developments must be closely monitored. Before replacing an existing program, evidence for non-inferiority in reducing cancer-specific mortality should be ensured. Benefits must outweigh harms, and citizens should have confidence in new screening schemes. With the pressure on health care resources, screening should continue in organized and monitored programs. Taking these conditions into account, the new screening tools will potentially enable improved cancer control.</p>}},
  author       = {{Lynge, Elsebeth and Andersen, Berit and Bojesen, Stig E. and Petersen, Lone Kjeld and Bech, Mickael and Bøgsted, Martin and Dam, Mie Seest and Egstrand, Søren and Hvass, Anne Mette Fløe and Kobylecki, Camilla J. and Lång, Kristina and Nielsen, Mads and Rossi, Giorgi Paolo and Stenger, Michael and Vejborg, Ilse}},
  issn         = {{0020-7136}},
  keywords     = {{cancer; evidence; screening}},
  language     = {{eng}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{International Journal of Cancer}},
  title        = {{Challenges in the future of cancer screening}},
  url          = {{http://dx.doi.org/10.1002/ijc.70286}},
  doi          = {{10.1002/ijc.70286}},
  year         = {{2025}},
}