Current Challenges in Imaging-Based Cancer Screening, From the AJR Special Series on Screening.

Area of Science:

• Oncology
• Radiology
• Public Health

Background:

• Early cancer detection significantly improves patient outcomes and lowers mortality rates.
• Radiology plays a crucial role in cancer screening, either independently or in conjunction with other tests.
• Screening programs require careful assessment of both benefits and potential harms.

Purpose of the Study:

• To review the challenges and evidence base for cancer screening programs.
• To explore the harms associated with cancer screening, including overdiagnosis and overtreatment.
• To highlight the importance of radiology in developing and executing effective screening guidelines.

Main Methods:

• Literature review of evidence supporting cancer screening programs.
• Analysis of harms associated with imaging-based screening modalities.
• Focus on common cancers with established imaging screening protocols.

Main Results:

• Imaging-based screening is vital for early cancer detection but carries risks such as overdiagnosis and false positives.
• Technological advancements in radiology necessitate adaptive screening recommendations.
• Radiologists are essential collaborators in creating and implementing screening guidelines.

Conclusions:

• Balancing the benefits and harms of cancer screening is critical for patient care.
• Radiology's role in screening is evolving, requiring continuous adaptation of guidelines.
• Multidisciplinary collaboration, led by radiologists, ensures optimal screening program quality.