Thursday, October 22, 2020

Making Decisions About Cancer Screening


The purpose of screening tests for cancer is to facilitate early detection of the disease. Early detection of cancer increases survival rates and reduces suffering from certain types of cancer including breast, colon, rectal, cervical, prostate, testicular, oral cavity, and skin.

Screening tests for early detection of cancer may include self-examinations, physical examinations by a health professional, X-rays or laboratory tests. Screenings are meant to be routine tests done before any warning signs are present. While some of the screenings may be a bit unpleasant, the discomfort is well worth the advantage provided by finding cancer early. Remember, consistent communication with your health-care provider before and during the screening process is essential for successful risk reduction.

Important Definitions Related to Cancer Screening

Screening —Testing people who have no symptoms and have not noticed any problems suggestive of disease. A particular screening test may be suggested for everyone or only for people with certain risk factors. Ideally, a screening test would be able to detect cancer at an early stage or before cancer has developed.

Early Diagnosis — Refers to detecting cancer early in its development. Early detection may occur through routine screening tests. For many cancers, early detection improves survival rates.

Prevention — Removing the cause or risk for a certain type of cancer. Screening is not considered prevention. Prevention often consists of life-style changes like quitting smoking or using sunscreen properly.

Screening Guidelines

The chart presented here provides guidelines for appropriate screening programs based on sex and age. Guidelines are given in terms of individuals at average risk. Individuals who are at higher risk for certain cancers should discuss an appropriate screening schedule with a health-care professional.

Cancer Site Recommendations
Cancer-Related Exam (Full Body) A cancer-related exam is recommended every threeyears for people 20­40 years of age and every year for those over 40 years. The purpose of the exam is to check the entire body for overall health and possible warning signs for cancer. The exam should include health counseling by a health professional and full-body exam including skin check and testes or pelvic exam.
Breast Women 18 years and older should perform a breast self-exam every month to detect unusual lumps or changes. The self-exam should include a visual and manual examination of the breasts. A health-care professional can provide instruction. Starting at age 20, a clinical breast exam should be performed every three years to detect unusual lumps or changes in the breasts. After age 40, this exam should be done yearly. The technique of visual and manual examination of the breasts in the clinical breast exam is similar to that done in self-exam except that it is performed by a trained health-care provider. A mammogram should be performed every 1­2 years beginning at age 40. Frequency should be yearly after age 50. The purpose of the mammogram is to detect lumps before they can be felt manually. This test is done by firmly compressing the breast for clear imaging by X-ray. The screening may produce discomfort but should not be painful. Many women experience less discomfort if mammograms are not scheduled during the week prior to or during the menstrual cycle.
Cervical At the onset of sexual activity or the age of 18, whichever comes first, women should begin yearly Pap tests. Pap tests detect abnormal (precancerous) cells in and around the cervix. Cells are collected from the cervix during a pelvic examination and sent to the laboratory for processing.
Colon/Rectal Beginning at age 50, men and women should have a digital rectal exam every year. This exam, performed by a health professional, detects growths or abnormalities in the rectum. The rectum is examined with a lubricated, gloved finger. Also beginning at age 50, a fecal occult blood test (FOBT) should be performed annually. This test finds occult (hidden) blood in a stool sample. A special diet is eaten for a few days then a stool sample is collected at home and returned to the laboratory for evaluation. Tests kits are available from health-care providers. Every five years, from age 50 on, a sigmoidoscopy should be performed. The purpose of this test is to examine the inside of the large intestine and rectum. A slender, lighted tube is inserted into the rectum for the exam. The colon must be cleansed prior to the test. Your health-care provider will instruct you on the desired method of colon cleansing.
Prostate Men aged 50 and over should have a yearly digital rectal exam and prostate specific antigen (PSA) testing. The purpose of the digital rectal exam is to detect abnormalities in the prostate. The rectum is examined manually by a health-care professional. The annual digital rectal exam for both rectal and prostate cancer can be done simultaneously by your health-care provider. The PSA test is used to detect the level of prostate specific antigens in the blood. A blood sample is drawn and sent to the laboratory for evaluation.
Skin Beginning at age 18, men and women should perform a skin self-exam monthly. The purpose of the exam is to detect changes in skin and moles. The entire body should be examined using a full-length mirror and a hand mirror. A health-care professional can provide further instruction if necessary.
Testicular Men aged 20 and over should perform a testicular self-exam regularly. This exam will help detect new or unusual growths or masses in the testes. Visual and manual examination should be performed. A health-care professional can provide instruction.

Remember that self-exams are intended to be performed in conjunction with health-care provider exams, not instead of health-care provider exams. Also, any changes observed during a self-exam should be discussed with a health-care provider promptly.

It is important to keep a schedule of required screenings and copies of all results in your health-care file. Remember that taking control of your future health may be instrumental in enjoying a long and healthy life!

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