Cancer Screening Guidelines
January 1, 2019
Early detection is critical to effectively treating and surviving of any type of cancer. The American Cancer Society makes the following recommendations for individuals with a normal risk of developing cancer. People have a family history of a particular type of cancer, or who have other risk factors may be advised to begin screening sooner or more often. Discuss your personal risk factors with your physician to determine if you should modify your screening schedule. Also, if you should develop symptoms that could be related to cancer, contact your physician immediately.
General checkups should begin at age 20. These periodic health exams should include general health counseling and could include screenings for cancers of the skin, lymph nodes, thyroid, mouth, testes, or ovaries.
Screening recommendations for other types of cancer are listed below.
Women need to be aware of the way their breasts typically feel and report any changes to their doctor immediately. Screenings in women with a normal risk of developing breast cancer should be done as follows:
- Women should begin Breast Self-Exams starting in their 20s.
- A Clinical Breast Exam should be done about every 3 years for women in their 20s and 30s, and every year for women 40 and older.
- Yearly mammograms should begin at age 40 and continue as long as the woman is in good health.
- Women with an increased risk of developing breast cancer may need to have a yearly MRI in addition to a yearly mammogram. Discuss your options with your physician.
Colorectal cancer is the second leading cancer killer for men and women in the United States. The American Cancer Society estimated that in 2007, more than 150,000 people were diagnosed with colorectal cancer and more than 52,000 people were expected to die from this disease.
Those figures are staggering because colorectal cancer is largely preventable. It is also successfully treated 90 percent of the time when found early. The high rate of mortality among people with colon cancer is blamed on the lack of participation in life-saving screenings.
“Less than half of adults age 50 or older have had a colorectal cancer screening within the recommended time period,” said Dr. Adam Ellis, a General Surgeon at Logan Memorial Hospital. “When detected at an early stage, colorectal cancer is nearly 100 percent curable, but only 40 percent of the cancers are diagnosed at this stage—mostly due to low rates of screening.”
Colorectal cancer can develop from polyps (fleshy growths) that form in the colon or rectum. Polyps and colorectal cancer may not cause any symptoms, especially at first. Over the course of several years, polyps can develop into cancerous growths without the patient even knowing they are there. Through a colonoscopy, a growth can be detected and removed before it becomes cancerous, or when the cancer is in its earliest, most curable stages.
More than 90 percent of people diagnosed with colorectal cancer are over the age of 50. Due to this fact, The American Cancer Society recommends that all men and women with a normal risk of developing colorectal cancer begin screening at age 50 following the guidelines below. Talk to your physician about which test is best for you.
Men and women with a normal risk of developing colorectal cancer should begin screening at age 50. Several screening options are available, so discuss your options with your physician. Since colon cancer often develops from non-cancerous polyps, the screenings that can detect both colorectal cancer and polyps are generally preferred. Screening options are as follows:
Screenings that find polyps and cancer (preferred method):
- Flexible Sigmoidoscopy every 5 years*
- Colonoscopy every 10 years
- Double Contrast Barium Enema every 5 years*
- CT Colonography (Virtual Colonoscopy) every 5 years*
Tests that can identify cancer:
- Fecal Occult Blood Test (FOBT) every year*,**
- Fecal Immunochemical Test (FIT) every year*,**
- Stool DNA Test (sDNA), interval uncertain*
*Colonoscopy should be done if test results are positive.
**For FOBT or FIT used as a screening test, the take-home multiple sample method should be used. A FOBT or FIT done during a digital rectal exam in the doctor's office is not adequate for screening.
People with an increased risk of developing colorectal cancer should begin screening at an early age or more often than listed above. As always, discuss your risk factors with your physician to determine the best screening options for you. Risk factors of colorectal cancer include:
- A personal history of colorectal cancer or adenomatous polyps.
- A personal history of chronic inflammatory bowel disease (Crohns Disease or Ulcerative Colitis).
- A family history of colorectal cancer or polyps.
- A family history of hereditary colorectal cancer syndromes such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colon cancer (HNPCC)
“Considering all of the available literature and research, conventional colonoscopy remains the gold standard for the diagnosis of colorectal cancer.” said Dr. Steve Reese, another General Surgeon serving Logan Memorial. “It is better for patients since the examination and polyp removal can be done in the same procedure. It also helps physicians make an accurate diagnosis because they can examine the entire length of the patient’s colon.”
The key to preventing, treating, and surviving colorectal cancer is early detection through regular screening. If you are over the age of 50 and have not had a colorectal cancer screening, talk to your doctor about the benefits of being screened.
Logan Memorial Hospital offers a full range of colorectal procedures including: Colonoscopy, Polypectomy, Upper Intestinal Endoscopy, Colon/Intestine Removal, Colon Resection, Hemicolectomy, Hemorrhoidectomy, Hemorrhoidal Disease Treatment, Perianal Abscess, and Sigmoidectomy.
Women should begin screening for cervical cancer about 3 years after they begin having vaginal intercourse, but no later than age 21. Cervical cancer screening recommendations are as follows:
- Regular screening should start no later than age 21. The regular Pap test should be done yearly, or, the liquid-based Pap test can be done every 2 years.
- At age 30, women who have had 3 normal Pap test results in a row may be able to reduce the frequency of screening to every 2 or 3 years. Women over 30 could also get screened every 3 years with one of the available Pap tests and the HPV DNA test. Discuss your options with your physician.
- At age 70, some women can choose to stop screening altogether. Those women who have had 3 or more normal Pap tests in a row and have had no abnormal Pap tests in the last 10 years should discuss the option of discontinuing screening with their doctor.
- Women who have a personal history of cervical cancer, HIV infection, diethylstilbestrol (DES) exposure before birth, or a weakened immune system should continue to be screened annually through their 70s and continue as long as they are in good health.
- Also, women who have had a total hysterectomy (removal of the uterus and cervix) may also be able to stop screening (unless the surgery was done as a treatment for cervical cancer or pre-cancer). Discuss your options with your physician. Women who have had a hysterectomy without removal of the cervix should continue to follow the guidelines above.
Currently, The American Cancer Society does not support routine testing for prostate cancer. Instead, they recommend that men who have a normal risk of developing prostate cancer discuss their screening options with their physicians beginning at age 50. Men with an increased risk of developing prostate cancer should talk to their doctors beginning as early as age 40.
Available screening methods include the Prostate-Specific Antigen (PSA) blood test and the Digital Rectal Exam (DRE). For men who choose to undergo prostate cancer screening, these tests are generally done yearly.