Let’s see how close we could get to this for, say, lung cancer. Screening tests we could consider are sputum cytology, X-rays and bronchoscopy. Sputum cytology is simple, safe and convenient for the patient. However, each specimen takes quite a few minutes to examine thoroughly and this must be done by a specially trained technician, so it is not cheap. There are false negatives— not all cancers shed cells into the sputum to be coughed up. Some do so erratically—there may be no cancer cells in the specimen that goes to the laboratory even if there were the day before and the day after. False positives are rare but occasionally other abnormal cells are mistaken for cancer cells. The test can pick up very tiny cancers at a stage when surgical removal would have a good chance of curing the patient. To pick up very early cancers, specimens would have to be examined every few months, which obviously would make it extremely expensive in the long run. Another problem occurs if the cancer is so small that it can’t be seen on X-ray. It then has to be located by bronchoscopy or special types of X-ray before it is possible to go ahead with surgical removal.
*82/40/1*
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