Cancer Screening: Cancers Detected, Who Needs It

How do doctors screen for cancer?

Doctors use various screening methods to detect cancer early, often before symptoms appear. The specific screening tests depend on the type of cancer being screened for and the individual’s risk factors, such as age, family history, and lifestyle. Here are some common cancer screening methods:

Breast Cancer

1. Mammography: An X-ray of the breast used to detect tumors that may not be felt during a physical exam.
2. Breast MRI: Used for women at high risk, often in addition to mammography.
3. Clinical Breast Exam (CBE): A physical examination of the breasts by a healthcare professional.

Cervical Cancer

1. Pap Smear (Pap Test): A test that collects cells from the cervix to look for abnormalities that may indicate cervical cancer or precancerous conditions.
2. HPV Test: Tests for the presence of high-risk human papillomavirus (HPV) types that can lead to cervical cancer.

Colorectal Cancer

1. Colonoscopy: A procedure that uses a long, flexible tube with a camera to view the entire colon and rectum. Polyps or suspicious areas can be removed and biopsied during the procedure.
2. Flexible Sigmoidoscopy: Similar to a colonoscopy but examines only the rectum and lower part of the colon.
3. Fecal Occult Blood Test (FOBT) and Fecal Immunochemical Test (FIT): Tests that check for hidden blood in the stool, which can be a sign of colorectal cancer.
4. CT Colonography (Virtual Colonoscopy): Uses CT scanning to produce detailed images of the colon and rectum.

Lung Cancer

1. Low-Dose CT Scan (LDCT): Recommended for high-risk individuals, such as heavy smokers or those with a long history of smoking.

Prostate Cancer

1. Prostate-Specific Antigen (PSA) Test: A blood test that measures the level of PSA, a protein produced by the prostate. Elevated levels can indicate prostate cancer.
2. Digital Rectal Exam (DRE): A physical examination where a doctor feels the prostate gland through the rectum to check for abnormalities.

Skin Cancer

1. Skin Exam: A thorough examination of the skin by a dermatologist or healthcare provider to check for suspicious moles or lesions.
2. Dermatoscopy: A tool used to examine skin lesions more closely.

Oral Cancer

1. Oral Exam: A visual and physical examination of the mouth, including the lips, tongue, and throat, to check for abnormalities.

General Guidelines for Screening

• Family History and Genetics: Individuals with a family history of certain cancers may need to start screening earlier or have more frequent screenings.
• Personal Risk Factors: Factors such as smoking, obesity, and exposure to certain chemicals can influence the type and frequency of screenings needed.

It’s essential to discuss with your healthcare provider which screenings are appropriate for you based on your individual risk factors and health history. Early detection through regular screenings can significantly improve the chances of successful treatment for many types of cancer.

Who should be screened for cancer?

Screening recommendations vary based on factors such as age, gender, family history, personal health history, and risk factors. Here are general guidelines for who should be screened for various types of cancer:

Breast Cancer

• Women aged 40-44: Should have the choice to start annual mammograms.
• Women aged 45-54: Should get mammograms every year.
• Women 55 and older: Should switch to mammograms every 2 years or continue yearly screening.
• High-risk women: Those with a family history of breast cancer, genetic mutations (e.g., BRCA1 or BRCA2), or a history of radiation therapy to the chest should start screening earlier and may benefit from additional tests like MRI.

Cervical Cancer

• Women aged 21-29: Should have a Pap smear every 3 years.
• Women aged 30-65: Should have a Pap smear combined with an HPV test every 5 years (preferred) or a Pap smear alone every 3 years.
• Women over 65: Can stop screening if they have had regular screenings with normal results.
• High-risk women: May need more frequent screenings if they have a history of cervical cancer, DES exposure before birth, HIV infection, or a weakened immune system.

Colorectal Cancer

• Adults aged 45-75: Should start regular screening with one of several tests: stool-based tests, colonoscopy, CT colonography, or flexible sigmoidoscopy.
• Adults over 75: Should discuss with their doctor whether to continue screening based on their overall health and prior screening history.
• High-risk individuals: Those with a family history of colorectal cancer, genetic conditions (e.g., Lynch syndrome), or a personal history of inflammatory bowel disease may need to start screening earlier and more frequently.

Lung Cancer

• Adults aged 50-80: With a history of heavy smoking (30 pack-years or more), currently smoke, or have quit within the past 15 years should have an annual low-dose CT scan.

Prostate Cancer

• Men aged 50: Should discuss the benefits and risks of screening with their doctor.
• Men aged 45: Should consider starting screening if they are at higher risk, including African American men and those with a family history of prostate cancer.
• Men aged 40: With a very high risk (more than one first-degree relative diagnosed at an early age) should discuss screening options.

Skin Cancer

• Individuals with a history of skin cancer: Should have regular skin exams.
• Individuals with a family history, fair skin, or a history of sunburns: Should consider regular skin exams and self-exams.

Oral Cancer

• Adults with risk factors: Such as tobacco use, heavy alcohol use, or a history of significant sun exposure should have regular oral exams.
• Regular dental visits: Dentists often screen for oral cancer during routine check-ups.

General Considerations

• Family History: People with a family history of certain cancers should discuss with their healthcare provider about starting screening earlier or having additional tests.
• Genetic Predisposition: Individuals with known genetic mutations (e.g., BRCA1/2) should follow specific screening recommendations provided by their healthcare provider.

Personalized Screening

It’s essential to have personalized discussions with healthcare providers to determine the most appropriate screening schedule based on individual risk factors and health history. Early detection through appropriate screening can significantly improve outcomes for many types of cancer.