Face your fear: early diagnosis of cancer

Cancer incidence is increasing in the developing world, mainly due to the increase in life expectancy but also due to increased urbanisation and the adoption of certain lifestyles that can increase the risk of cancer. More than 90 per cent of women diagnosed with breast cancer at an early stage survive the disease for at least five years compared to about 15 per cent of those diagnosed with the most advanced stage of the disease ( Cancer Research UK).

There are several possible reasons that lead to a late diagnosis of cancer. The most common cause is the low awareness of signs of the disease by the individual, meaning that they do not approach their healthcare providers as soon as they have the first suspicious symptoms, thus delaying diagnosis. Additionally, some people are too worried to approach their doctor with certain symptoms because of what the doctor might find and diagnose them with.

There are two major groups of activities that can play an important role in increasing the early detection of cancer. These are mainly education to promote the early diagnosis and referral for suspicious symptoms and signs of cancer and screening for asymptomatic (before any noticeable symptoms appear) signs of cancer. En- couraging individuals to learn about how to recognise the possible warning signs of cancer is the first important step leading to an early diagnosis. The individual should be made aware of possible warning signs, for example: lumps, abnormal bleeding, sores that fail to heal and chronic hoarseness. Early diagnosis of cancer has a major impact on several cancers, including cancers of the breast, mouth, cervix, colon and rectum, lung, larynx and skin. One important resource is the European Code against Cancer, which can be accessed at https://cancer-codeeurope.iarc.fr/index.php/en/

Adult women of all ages are encouraged to perform breast self-examination in the comfort of their own home. Forty per cent of diagnosed breast cancers are detected by women who approach their healthcare provider after feeling or noticing something different in their breasts (John Hopkins Breast Centre). While mammograms can help detect breast cancer before one can feel a lump, doing regular breast self-exams can help the individual to be familiar with how their breasts look and feel and notice if there are any changes. However, education by itself is not enough when it comes to the early diagnosis of cancer and individuals should always accept invitations that are sent to them to participate in organised cancer screening programmes.

Screening for cancer takes place when simple tests are performed on healthy individuals to search for any possible signs of early stages of cancer even before (often long before) there are any demonstrable symptoms. There are two distinct types of screening methods: organised population-based screening programmes and opportunistic case-finding tests. The latter usually happen when an individual goes to see her or his healthcare provider for reasons that may be unrelated to the disease and a cancer-screening test is offered. On the other hand, organised populationbased cancer screening programmes invite members within set population age and gender groups to attend screening tests on a regular time basis.

Organised population-based cancer screening programmes for breast cancer have been shown to be effective in reducing the incidence or improving the prognosis of three common cancers: namely cervical, breast and colon. In Malta, the national screening programme for breast cancer was introduced in 2009 and is presently inviting women from the ages of 50 to 67 years to attend for screening mammography every 2-3 years.

Let us all keep an open mind, make sure we know our bodies well and accept screening invitations. Face your Fear is the slogan of this year’s Pink October Campaign. We are stronger than fear. Let’s tackle cancer together because together we can beat cancer.