ABSTRACT
This chapter focuses on the development of screening programmes in the United States, and especially those for breast and cervical cancers. Screening for cancer had roots in early-twentieth-century programmes of early detection and treatment, which aimed to catch a growth as early in its life as possible, ideally before it turned malignant, and to treat it the moment cancer or something that might turn into cancer was discovered. In the 1940s, mass screening joined the armamentarium of early detection and treatment, first in cervical cancer and then breast and other cancers. Screening aimed to extend the reach of early detection and treatment programmes from the individual patient to the population. The history of the Pap test – the first mass screening technology for cancer – illustrates the complexities of initiating screening programmes for cancer and the porous boundary between diagnosis and screening. Mammography had resulted in over-diagnosis and over-treatment.
