Scientists urge Europe to shift focus to bowel cancer screening
European
governments should divert funds to routine
bowel cancer tests from less effective breast
and prostate screening programs, scientists
said on Saturday, presenting what they called
"irrefutable" evidence that bowel screening
saves lives.
Many governments devote significant funds
to breast cancer screening, but studies in
recent years have found that routine breast
mammograms can also lead to so-called
"over-diagnosis" when tests pick up tumors
that would not have caused a problem.
And a new study presented at the European
Cancer Conference (ECC) in Amsterdam at
the weekend showed men experience more
harm than good from routine prostate cancer
screening tests.
In bowel cancer screening, however, the risk
of over-diagnosis is very low, while gains in
terms of reducing deaths are large - making
routine testing cost-effective, Philippe Autier,
a professor at France's International
Prevention Research Institute (IPPR), told the
conference.
"There is now an irrefutable case for
devoting some of the resources from breast
and prostate cancer screening to the early
detection of colorectal (bowel) cancer," he
said.
A large European study published last year
found that breast screening programs over-
diagnose about four cases for every 1,000
women aged between 50 and 69 who are
screened.
The IPPR's research director Mathieu Boniol,
who studied the impact of prostate
screening, said his results showed routine use
of prostate-specific antigen (PSA) tests
creates more harm in terms of incontinence,
impotence and other side-effects from
prostate cancer treatments than benefit in
terms of detecting life-threatening cancers.
"PSA testing should be reduced and more
attention should be given to the harmful
effects of screening," he told delegates.
Meanwhile, results of a study conducted by
Autier using data from 11 European countries
between 1989 and 2010 showed that the
greater the proportions of men and women
routinely screened for bowel cancer, the
greater the reductions in death rates.
Colorectal cancer kills more than 600,000
people a year worldwide, according to the
World Health Organization. In Europe some
400,000 people are diagnosed with the
disease each year.
In Austria, for example, where 61 percent of
those studied reported having had colorectal
screening tests, deaths from this form of
cancer dropped by 39 percent for men and 47
percent for women over the decade.
Meanwhile in Greece, where only 8 percent
of males had had bowel cancer screening,
death rates rose by 30 percent for men.
In the light of the results, Cornelis van de
Velde, an oncologist at Leiden University
Medical Centre in the Netherlands and
president of the European Cancer
Organisation, said it was "very
disappointing" there are such wide
differences in European governments'
approaches to colorectal screening.
"People over 50 should be informed of the
availability of the test, and pressure should
be put on national health services to put
more effort into organizing screening
programs," he told the conference.
Screening for early signs of bowel cancer
involves either a fecal occult blood test,
which checks a sample of feces for hidden
blood, or endoscopy, where a tiny camera is
introduced into the large bowel to look for
the polyps that can be a precursor of cancer.
In some European countries, such as France,
Germany and Austria, many men and women
over the age of 50 have regular colorectal
screening examinations, while in others, such
as The Netherlands and Britain, screening is
much less common.
