Presentation (CTI)

OBJECTIVES: To avoid unnecessary screening, the balance of benefits and harms was compared across age groups in cancer screening.
METHODS: To assess the balance of benefits and harms of each cancer screening, expected benefits and harms were calculated assuming 10,000 individuals participated in screening, based on data from a national survey. The benefit was defined as the number of screen-detected cancers. The harm was defined as the number of individuals requiring further diagnostic examinations following a positive result from screening. For cervical cancer screening, the target lesions included cervical intraepithelial neoplasia 3 in addition to cervical cancer.
RESULTS: As we will see in the following examples, for lung cancer screening, the number of benefits and harms per 10,000 participants were 6 and 39, respectively. For gastric cancer screening using endoscopy, the numbers of benefits and harms per 10,000 participants were 33 and 11, respectively. For colorectal cancer screening, the numbers of benefits and harms per 10,000 participants were 24 and 28, respectively. In both screenings, the benefits outweighed the harms among individuals aged 70 years or older, whereas this pattern was not consistently observed among individuals under 60 years. For breast cancer screening, the number of benefits and harms per 10,000 participants were 37 and 15, respectively. Among participants in their 40s, the numbers of benefits and harms were nearly equivalent, whereas the benefits increased with age among those aged 50 years and older. For cervical cancer screening, the number of benefits and harms per 10,000 participants were 12 and 8, respectively. Although the benefits outweighed the harms among individuals aged 30-49 years, in contrast to previous examples, the harms outweighed the benefits among those aged 20 years old.
CONCLUSIONS: Considering the balance between benefits and harms, the appropriate starting age for cervical, colorectal, and gastric screening should be reconsidered.