Screening Programmes for early Cancer Detection - Zora

Cancer screening programmes

Screening is a public health strategy that aims to identify those members of the apparently healthy population who are at greater risk of the disease for which screening is carried out. Screening is done by means of reliable and relatively simple screening tests carried out at regular intervals among the specific age groups most at risk of the disease in question in order to detect precancerous and early cancerous lesions.

Slovenia is one of the few countries to have established all three cancer screening programmes recommended by the Council of Europe at the nationwide level. The first to be established was the ZORA programme for the detection of precancerous and early cancerous cervical lesions. This programme was introduced nationally in 2003. All women aged between 20 and 64 are invited for a cervical smear test every three years. The test is carried out by their chosen gynaecologist. The DORA screening programme for the early detection of breast cancer began to be introduced in 2008 and was extended to cover the whole country in 2018. In this screening programme, women aged 50–69 are invited to undergo a mammography check every two years. The SVIT programme offers prevention and early detection of colorectal cancer by screening for precancerous and cancerous lesions. The programme was established in Slovenia in 2009 and covers men and women aged between 50 and 74. Every two years the individual is invited to undergo a faecal occult blood test (also known as a blood in stool test). It is important to realise that none of the screening tests offer a definitive diagnosis: they merely indicate the greater probability of the presence of disease. If a screening test within a screening programme is positive, the individual is invited to undergo further diagnosis, which will either confirm or reject the diagnosis of cancer. In the event of the confirmation of a cancer diagnosis, the individual is referred for further treatment.

The purpose of screening is to prevent the development of cancer through the removal of precancerous lesions or to detect the disease at a very early stage when less invasive treatment is required, the success of treatment is greater and the patient’s quality of life is better. The long-term aims of screening programmes are to reduce the incidence of a specific form of cancer or reduce mortality from that cancer. The response of invited individuals is crucial for the success of screening, since we can only expect the programmes to be successful if more than 70% of the target population regularly participates in screening. For this reason, we continue to urge all citizens to respond to invitations to participate in cancer screening programmes.

In Slovenia we are already recording successes in all three cancer screening programmes. Participation ranges from 68% to 74% and in the cases of cervical cancer and colorectal cancer we are observing a reduction in new cases, although the impact of screening programmes on reducing mortality will only be observable in subsequent years. By working together, we can be confident of success!

Sonja Tomšič MD

National Cancer Control Programme 2017–2021

Ljubljana Institute of Oncology