In 2022, colon cancer screening linked to the National Cancer Screening Program will be expanded to a new age group next year.
Screening will be expanded to younger adults, and by 2031 screening will be at its full scope, reaching men and women aged 56-74. This year, 420,000 men and women were invited for colon cancer screening. The same number will be called in 2024. A new age group joins each year.
– These screening programs are very large. 2031 is the first year the entire target group will be screened. Then 700,000 people will be called, says the screening director of the Finnish Cancer Registry girl branch area.
Screening is worthwhile because bowel cancer screening can reduce bowel cancer mortality by 30-50 percent in people who participate in screening. By 2022, hundreds of colon cancers and cancer precursors will be detected in cancer screenings.
– According to preliminary estimates, around 550 cancers have been diagnosed so far. More than three thousand advanced precursors have been discovered, Sarkela says.
Bringing up the timing of breast cancer screening is under investigation
Another cancer included in the national screening program is breast cancer. The age limit for screening is currently 50-69 years, and 350,000 women are invited for screening each year.
There is no change in breast cancer screening next year, but a cost-effectiveness analysis of the expansion of screening is due to be completed early next year.
– I don't think screening will expand next year, but we are moving in that direction. Of course, Sarkela reckons it all comes down to money.
Recent European studies suggest that expansion of breast cancer screening may be especially beneficial in younger age groups.
– In Finland, this means that 46 and 48-year-olds are invited for screening. Here in Finland the preliminary results look like this. We have also surveyed 70-74 year olds and the results of this analysis will be published at the beginning of the year.
A cost-effectiveness analysis evaluating the expansion of breast cancer screening quantifies for the first time the cost per additional organ year of screening. For example, the annual cost of an extra organ for colon cancer is less than 10,000 euros.
– Bowel cancer screening is very cost-effective, says Sarkela.
Cervical cancer screening frequency is reduced among vaccinated people
Cervical cancer screening will continue next year as before. In Finland, the primary screening test for women over 30 is the HPV test. After that, if the HPV test is positive, a Pap test is done.
What is new is that in future welfare areas, home samples should be provided to women who do not participate in screening despite the invitation.
HPV vaccines reduce the risk of cervical cancer. Therefore, experts are currently investigating what is a reasonable way to screen vaccinated and unvaccinated young women in the future.
– I would say that everyone gets their first invitation at the age of 30, but how many times after that, we still have to inquire, says Titi Sargela.
Prostate cancer screening is being studied in a new way
The feasibility of prostate cancer screening is currently being studied in Finland.
Prostate cancer was screened in previous studies by a marker test measured in the blood, the so-called PSA method. The problem with the test is that it cannot distinguish fast-growing, dangerous cancers from slow-growing and harmless ones.
Overdiagnosis is a problem when treatment can have a significant impact on patients' quality of life.
The new ProScreen study currently examines the suitability of a combination of three different screening tests. Randomized research is being conducted in Tampere and Helsinki.
– It will take a few more years to see if the screening test affects prostate cancer mortality, Sarkela says.
Trial of lung cancer screening begins
The European Union recommends introducing lung cancer screening for smokers.
A pilot study on this subject is to start in Finland next year, together with Hungary. The screening method combines smoking cessation counseling, therapy, and computed tomography.
The aim of the pilot phase was to find out whether screening could be widely implemented in the target group, i.e. long-term smokers. If all goes as planned, the first evidence from the pilot study could be in 2028.
– Sargela plans to start the pilot in 2025 with the Hungarian and Finnish population if the expert group's plan is approved.
Look at Yle Areena: Finland has yet to expand breast cancer screening to women under fifty, despite EU recommendations. Sarah Laithila's cancer was diagnosed at age 46 in a study she paid for herself.