“An ounce of prevention is worth a pound of cure.” Benjamin Franklin was not referring to cancer, but rather the prevention of fires, when he made this statement.

However, for many of the cancers we deal with in the clinic, prevention may indeed be the best strategy, as an effective cure may not exist. It is amply clear that most cancers take a long time, often decades, to get to their clinically suspected and diagnosed phase, one that may be too late for a cure at that point, either because it is widely metastatic and without a surgical option, or due to the lack of a curative drug or combination. The efficacy of screening approaches is judged by the number of lives saved among the screened population, but this, in turn, depends on many factors, most importantly, access to diagnostic tools and effective treatments in a timely manner. Given the limitations of access in resource-constrained settings of developing countries, the impact of cancer screening is likely to be amplified many times compared to what is observed in developed nations.

With the cancer incidence reaching epidemic proportions, it is time for us to turn our full attention to screening, early detection, and cancer interception, especially in developing countries. Managing advanced cancer will need trained oncologists and nurses, extensive hospital infrastructure, access to expensive therapies that can come at the cost of redirecting resources from more pressing healthcare needs, and untold human suffering and lost productivity, especially when cancer strikes the young. Balance this against comprehensive screening approaches that can be conducted with community health workers or primary care providers, using limited equipment and simple blood tests, directly in the community, thereby allowing access to the largest population possible. The answer is obvious. How do we get there? This requires the development of a strong policy by the government, as well as the active engagement of NGOs with a focus on cancer prevention, philanthropic support, leveraging corporate social responsibility, educating primary care providers, and implementing direct-to-patient education and awareness campaigns. Equally important is for us to develop and implement prospective clinical trials of cancer screening in our population, rather than relying on results from the West, as these findings are not generalisable from one population to another, unlike treatment trials. This will also serve to raise awareness and understand the barriers to population-wide implementation.

We have had success stories, especially with cervical cancer screening, a feat that can certainly be replicated in many cancers. These steps are not a replacement for cancer prevention strategies like anti-tobacco strategies and HPV vaccination, but screening for early cancer will complement and strengthen these approaches to ensure that the full-blown, incurable cancer never happens in the first place, the best scenario! We have the tools we need, the understanding of the disease that we previously lacked, and what we need now is the determination to make universal age-appropriate cancer screening an integral part of healthcare for the 1.5 billion individuals in the country.