Modernising management of cancers: Prevent,screen and improve precision in treatment

Welcome to the May 2025 issue of the Scottish Medical Journal!

This issue contains two very diverse topics. Nikoghosyan et al. ¹ share their experience of using robotics-assisted surgical approach in radical nephrectomy procedures. They show increased efficiency and reduction of clinical practice variation from their hospital. The study did not report any cost analysis/impact of service, however, and this has to be balanced against the investment in robotics technology. Some evidence has emerged supporting minimal trauma with a robotics-assisted approach. The latter translates into early recovery and faster hospital discharges. ² Despite reservations about the financial impact, robotics-assisted surgical approaches for radical nephrectomy procedures have been increasing. A 12-year data from 700 acute hospitals in the USA between January 2003 and September 2015 using ICD-9 code (55.51) for the procedure clearly supports penetration of the technology in clinical practice. ³

Implementation of emerging or new technologies for healthcare depends to a large extent on careful planning and policy making. A good technology with no robust healthcare implementation policy can potentially lead to inequity in healthcare. ⁴ The latter can cause damage to many and advantage to few.

The issue also brings another piece of research presentation by Keles and Toker ⁵ where they have used various tools to reduce pain during cervical cancer screening. Screening for cancers, in particular for cervical cancer still needs a higher degree of persuasion and encouragement. This article – a randomised controlled trial adds to research evidence aimed at improving the uptake of the screening programme for cervical cancer. I encourage the readership of the journal to go through this manuscript including accompanying editorial and contribute to the topic in the future.