Cancer screening in the spotlight in latest issue of Public Health Research & Practice

Cancer screening in the spotlight in latest issue of Public Health Research & Practice


Australia’s screening programs for breast, cervical and colorectal cancers are all cost-effective, with benefits substantially outweighing harms for the latter two cancers, according to major new research published in Public Health Research & Practice (PHRP), a journal of the Sax Institute.

The research article – whose senior author is Professor Karen Canfell, Chair of the Cancer Screening and Immunisation Committee, Cancer Council Australia – is the first comprehensive review of the benefits, harms and cost-effectiveness of cancer screening in Australia, using quantitative evidence and the most recent estimates.

If finds that the bowel and cervical cancer screening programs are cost effective, with bowel cancer screening having an exceptionally favourable benefit-to-harm balance. It suggests that further work is needed on the benefits and harms (such as overdiagnosis and overtreatment) of Australia’s BreastScreen program, as well as other emerging screening approaches.

Cancer screening in Australia is the focus of the latest issue of PHRP, which was supported by and developed in partnership with Cancer Council Australia and Cancer Institute NSW. Articles explore a range of topics on this theme, from ways to increase participation in the bowel screening program to new approaches and technologies to improve breast screening.

A perspective series of articles looks at the state of play and potential for screening for skin, lung, liver and prostate cancers, as well as for the genetic condition Lynch syndrome, which predisposes carriers to colorectal and other cancers.

The authors suggest there may be opportunities to prevent thousands of deaths through targeted screening for melanoma and lung cancer, systematic testing for Lynch syndrome and organised surveillance for hepatocellular carcinoma in people at high risk, although population-wide screening for these conditions is not currently warranted.

In an editorial, Professor Sanchia Aranda, CEO of Cancer Council Australia and Professor David Currow, CEO of the Cancer Institute NSW, state that while emerging knowledge of risk factors for different cancers opens the door to new risk-stratified approaches to screening, this will make both the system and the messaging to the public more complicated.

Other articles find that:

  • Simulation modelling could play a key role in identifying the harms and benefits of population screening policies.
  • GP endorsement may be one of the most effective ways to boost low levels of participation in the National Bowel Screening Program
  • We need to address screening inequities if we are to eliminate cervical cancer as a public health threat by 2040

PHRP is Australia’s first online-only open access peer-reviewed public health journal, with a strong focus on connecting research, policy and practice.

Researchers are welcome to submit manuscripts and encourage their colleagues to submit. You can also subscribe to receive quarterly e-alerts when the journal is published, make suggestions about themes or topics for future issues, and follow us on Twitter @phrpjournal