Cancer Screening
In 2020, according to the CDC, cancer was the second leading cause of death in the United States.
There are ways to screen asymptomatic patients for certain types of cancer and find them early.
The cancer screening guidelines used for this post will focus on lung, breast, colorectal, cervical, and prostate cancers.
The United States Preventative Task Force (USPTF) and American Cancer Society (ACS)have recommended guidelines that are periodically updated as new scientific data emerge and new screening technologies become available.
Your annual visit with your Health Care Provider (HCP) is the best time to discuss cancer screening according to your risks.
Lung Cancer:
According to the USPTF, lung cancer is the leading cause of cancer deaths in the United States.
New lung cancer cases are decreasing due to people quitting smoking and early detection and treatment advances.
Yearly cancer screening with Low-Density Computerized Tomography (LDCT) is recommended for people aged 50-80 with a 20-pack-year history who continue to smoke or quit within the past 15 years. Pack year history is calculated by multiplying the number of cigarettes smoked daily by the number of years. For example, one pack a day for 20 years equals a 20-pack-year history.
Breast Cancer:
Women should undergo self-breast exams to know how their breasts feel and look and what is expected and to report any changes to their Health Care Provider (HCP) immediately.
The American Cancer Society suggests guidelines on breast cancer screening based on your risk factors. If you don't have a history of breast cancer, a strong family history of breast cancer, or a genetic mutation identified by testing and have not had any chest radiation before age 30, you can begin screening at age 40 and should continue every year.
Screening should continue if the woman is in good health and is expected to live ten years or longer.
Women at high risk of breast cancer should begin mammograms at age 30 and have a breast MRI.
Colon and Rectal cancer, including Polyps:
Colorectal cancer is the third leading cause of cancer and one of the most preventable.
It is recommended that people at average risk for developing colorectal cancer screening begin at age 45 and continue as long as they are in good health to age 75. Testing should include regular screening with either a high-sensitivity stool-based test or a direct visualization examination.
High-sensitivity stool-based tests include a fecal immunochemical test (annually), a high-sensitivity guaiac-based fecal occult blood test (annually), or a multitarget stool DNA test (every three years) with a positive result will require a follow-up colonoscopy.
Direct Visualization Tests, including colonoscopy, CT colonography, and flexible sigmoidoscopy, will be repeated based on the findings and personal family history.
Ages 76-85 should discuss with their HCP and base their decision on patient preferences, life expectancy, health status, and prior screening.
Ages 85 and above should not be screened and can discuss with their HCP in regards to risks and benefits.
Cervical Cancer:
USPSTF recommends the following screening in women before age 21-65 who have a cervix, regardless of their sexual history or HPV vaccination status:
Women ages 21 to 29 every three years with conventional or liquid-based pap tests.
Women ages 30-65, the guidelines recommend screening with HPV and Pap tests every five years or every three years with the Pap test alone.
Women 65 years and older who have had three or more consecutive negative Pap tests or two or more consecutive negative HPV and Pap tests within the last ten years, with the most recent test occurring in the previous five years, can stop cervical screening.
The following recommendations do not apply to individuals diagnosed with a high-grade precancerous cervical lesion or cervical cancer, having been exposed in utero to diethylstilbestrol, or having compromised immune systems, such as those living with HIV.
Prostate Cancer:
The American Cancer Society recommends PSA Screening with or without digital rectal examination for prostate cancer in males 50 and older. If you are at risk of developing prostate cancer based on African heritage and strong family history, begin at age 40-45.
Get regular check-ups and screening tests to reduce your cancer risks. Stop smoking, reduce or limit alcohol use, get in shape by eating healthy and exercising, protect your skin, and get vaccinated. It is essential to know your family history and your risks. If diagnosed early and treated, many cancers have a good chance of cure - do your part!