What Exactly Is Cancer Screening? A Guide to Cancer Screening in Nepal
Cancer Screening means checking for cancer before its symptoms appear. The screening for cancer is done to detect certain selected cancer early so that the treatment can be more effective and to increase the positive result of the cancer treatment. The cancer screening in Nepal is recommended based on different factors such as age, sex, family history and overall health. What Is Cancer Screening? Cancer screening is the process of looking for cancer or pre-cancerous changes in people who do not have symptoms. The National Cancer Institute explains that screening tests aim to find cancer before symptoms develop, when it may be easier to treat successfully. A simple way to understand cancer screening is tabulated below: Term Meaning Screening Testing apparently healthy people to look for early cancer or pre-cancer Diagnosis Confirming whether cancer is present after symptoms or abnormal screening Monitoring Follow-up testing after cancer treatment or after a known abnormality Risk assessment Estimating someone’s chance of cancer based on age, family history, habits, genes, or medical history Screening does not mean a person has cancer. It means the doctor is checking whether further evaluation is needed. For example, a mammogram may detect an abnormal breast area. That does not automatically mean breast cancer. It may lead to additional imaging, clinical examination, or biopsy if needed. Similarly, a positive stool test does not confirm colon cancer, but it tells the doctor that colonoscopy may be required. Why Is Cancer Screening in Nepal Important? Cancer screening in Nepal is important because many cancers are still diagnosed late, often after symptoms become obvious. Late diagnosis can make treatment more complex, expensive, and emotionally difficult for patients and families. According to IARC’s CanScreen5 Nepal fact sheet, Nepal’s overall cancer incidence is estimated at 81.6 per 100,000 persons per year, while cancer mortality is 55.3 per 100,000 persons per year. Cervical cancer is listed as the most common cancer site by incidence and mortality among females, while lung cancer is listed as the most common cancer site by incidence and mortality among males. Nepal has also introduced national level cancer prevention and control planning. The Ministry of Health and Population launched the Nepal Cancer Control Strategy 2024-2030, covering prevention, early detection, diagnosis, treatment, and palliative care. This matters because screening is only useful when it is connected to the next steps: proper diagnosis, timely referral, and access to cancer treatment in Nepal when required. What Types of Cancer Can Be Screened For? Not every cancer has a recommended screening test for the general population. Good screening tests are used when evidence shows they can detect disease early enough to make a meaningful difference. The CDC highlights screening for breast, cervical, colorectal, and lung cancers as major evidence based screening areas. Common cancer screening tests include: Cancer Type Common Screening Method Who May Need It Cervical cancer HPV test, Pap smear, VIA Women in recommended age groups Breast cancer Mammography, clinical breast exam Women based on age and risk Colorectal cancer FIT/stool test, colonoscopy Adults from recommended age groups or earlier if high risk Lung cancer Low-dose CT scan Heavy smokers or former smokers in specific age/risk groups Oral cancer Mouth examination Tobacco, betel nut, alcohol users, or suspicious lesions Prostate cancer PSA blood test with doctor discussion Selected men after shared decision-making The right test depends on the person. A 32 year old woman, a 50 year old man who smokes, and a 45 year old person with a family history of colon cancer may need very different screening plans. Cancer Screening in Nepal: Which Tests Are Most Relevant? 1. Cervical Cancer Screening in Nepal Cervical cancer screening is one of the most important public health priorities in Nepal. WHO recommends starting regular cervical cancer screening at age 30 for the general population of women, with priority for women aged 30-49. WHO also notes that women living with HIV may need earlier screening from age 25. In Nepal, older national guidance recommended VIA screening every 5 years for women aged 30-60. A 2024 PLOS Global Public Health paper notes that Nepal’s 2010 national cervical screening guideline recommended visual inspection with acetic acid every 5 years in women aged 30–60, while also reporting that Nepal has no national or regional breast cancer screening program. Cervical screening may include: Test What It Checks VIA Visual inspection of the cervix after applying acetic acid Pap smear Abnormal cervical cell changes HPV DNA test High-risk HPV infection linked to cervical cancer risk Cervical cancer is often preventable because screening can detect pre-cancerous changes before they become cancer. HPV vaccination is also important, but vaccination does not replace screening in adulthood. Nepal has made progress in HPV vaccination. WHO Nepal reported that the government aims to fully vaccinate 90% of girls aged 10-14 and ensure that at least 90% of women aged 30-49 receive cervical cancer screening by 2030. 2. Breast Cancer Screening Breast cancer screening usually involves mammography, which is an X-ray of the breast. A mammogram can sometimes detect cancer before a lump is felt. The USPSTF recommends biennial screening mammography for women aged 40-74 years. This recommendation applies to women at average risk and some women with common risk factors, but women with very high risk may need individualized advice. Breast screening may involve: Method Purpose Breast awareness Knowing your normal breast changes and reporting concerns Clinical breast exam Doctor examination when symptoms or concerns exist Mammography Screening test for early breast cancer detection Ultrasound/MRI Additional tests in selected cases, not routine for everyone In Nepal, access to mammography may vary by location. People in Kathmandu and major cities may have easier access than those in rural areas. That is why awareness, timely consultation, and referral pathways are important. A medical oncologist in Nepal may not be the first doctor you see for breast screening, but they become important if cancer is diagnosed or if treatment planning is needed. 3. Colorectal Cancer Screening Colorectal cancer affects the colon or rectum. Screening can detect early … Read more
