Follow the National Cancer Screening Guidelines

On Nov. 25, a report regarding the timeliness of cancer diagnosis was released by the Centers for Diseases Control and Prevention.  The news was not good.  Almost half of colorectal and cervical, and one-third of breast cancer cases in the U.S. are diagnosed in relatively late stages.  This is particularly discouraging because these cancers can be diagnosed at earlier stages when the disease is curable. If we all were to follow national cancer screening guidelines, lives would be saved.

Cancer screening tests are employed to diagnose cancer before a patient has any signs or symptoms of disease.  The rationale for such testing is that if we can find cancers when they are small, they are more amenable to cure.  There are different screening tests: history and physical examination, blood tests, radiologic imaging and genetic testing are the most common.  The best test to use depends upon the cancer in question. For many cancers, unfortunately, there is no evidence that any screening is helpful.

Like any medical test, screening tests are not perfect. Some will miss cancer in its early stages--this is called a "false negative examination." Others will come back as positive, but further tests will reveal no evidence of cancer--this is called a "false positive examination."  Some tests may have small risks associated with them.

The American Cancer Society has guidelines for screening by age (www.cancer.org/Healthy/ToolsandCalculators/Reminders/screening-recommendations-by-age).  In particular, for average risk patients, the Society urges:

Colorectal cancer--begin screening at age 50.

Cervical cancer--screening should begin 3 years after women begin having vaginal intercourse, but no later than 21 years old.

Prostate cancer--a controversial area. Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment.  Starting at age 50, men should discuss the issue with their primary care physician

Cancer related check-ups--starting at age 20 a periodic physical examination should focus on your thyroid gland, lymph nodes, oral cavity, testes and ovaries.

There is a list of cancers for which there is no clearly accepted screening protocol. This includes lung, ovarian, stomach and pancreas. However, there is much ongoing research (i.e., CT scanning to screen smokers for lung cancer) and so the recommendations may change over time.

Of course, there are important lifestyle choices which can impact upon your risk of developing cancer. Staying away from tobacco, eating healthy with multiple fruits and vegetables daily, maintaining an appropriate weight, limiting alcohol, using sunblock when outside and having a personal primary care physician are the components of a personal anti-cancer lifestyle.