Screening in gynecologic oncology

Practical value of screening depends on various characteristics of cancers themselves, suitable tests and programs being able to cover a sufficient part of the population. Cancers favourable for screening are those with a high prevalence in the population screened, a detectable preclinical stage and better treatment results if detected by screening than detected by symptoms. Suitable screening tests have to be highly sensitive and specific, simple, cheap and without any risk. Before the widespread application of a screening program as a public health measure scientific basis and rational organization should be well known and the benefit has to be evident. Cytological screening is the most effective measure in cervical cancer control. Screening also promises a reduction in mortality from breast cancer, but further evaluation is necessary before decisions can be made about the application as a public health measure. Selective screening is probably connected with an improved health care for high risk persons of endometrial cancer. Follow up with HCG-RIA after hydatidiform mole improves early detection and prognosis of trophoblastic neoplasias significantly.