By Jean Lillquist
February is cancer screening and awareness month. As you are no doubt aware, recommendations for testing have changed (seesawed even) as more research continues to be done. False positives can cause anxiety and lead to unnecessary procedures, while false negatives can cause delays in treatment. Screening tests may be read or interpreted incorrectly or their accuracy compromised and the body itself may present a problem (women with dense breast tissue know all about this). Nevertheless, most health organizations recommend three important screening tests. These are for colon and colorectal cancer, breast cancer, and cervical cancer. Prostate and lung cancer screenings can also be done but are not considered mandatory. See below for those considered most important from the American Cancer Society.
Breast Cancer Screening Guidelines
- Women ages 40 to 44 should have the choice to start annual breast cancer screening with mammograms (x-rays of the breast) if they wish to do so.
- Women ages 45 to 54 should get mammograms every year.
- Women 55 and older should switch to mammograms every 2 years, or can continue yearly screening.
- Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer.
All women should be familiar with the known benefits, limitations, and potential harms linked to breast cancer screening. They also should know how their breasts normally look and feel and report any breast changes to a health care provider right away.
Colon and Rectal Cancer Screening Guidelines
Starting at age 50, both men and women should follow one of these testing plans:
Tests that find polyps and cancer
Flexible sigmoidoscopy every 5 years*, or Colonoscopy every 10 years, or Double-contrast barium enema every 5 years*, or
CT colonography (virtual colonoscopy) every 5 years*
Tests that mostly find cancer
Yearly guaiac-based fecal occult blood test (gFOBT)**, or Yearly fecal immunochemical test (FIT)**, or Stool DNA test (sDNA) every 3 years*
* If the test is positive, a colonoscopy should be done.
** The multiple stool take-home test should be used. One test done in the office is not enough. A colonoscopy should be done if the test is positive.
Cervical Cancer Screening Guidelines
- Cervical cancer testing should start at age 21. Women under age 21 should not be tested.
- Women between the ages of 21 and 29 should have a Pap test done every 3 years. HPV testing should not be used in this age group unless it’s needed after an abnormal Pap test result.
- Women between the ages of 30 and 65 should have a Pap test plus an HPV test (called “co-testing”) done every 5 years. This is the preferred approach, but it’s OK to have a Pap test alone every 3 years.
- Women over age 65 who have had regular cervical cancer testing in the past 10 years with normal results should not be tested for cervical cancer. Once testing is stopped, it should not be started again. Women with a history of a serious cervical pre-cancer should continue to be tested for at least 20 years after that diagnosis, even if testing goes past age 65.
- A woman who has had her uterus and cervix removed (a total hysterectomy) for reasons not related to cervical cancer and who has no history of cervical cancer or serious pre-cancer should not be tested.
- All women who have been vaccinated against HPV should still follow the screening recommendations for their age groups.
The American Cancer Society recommends that men make an informed decision with a health care provider about whether to be tested for prostate cancer. Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment. The ACS believes that men should not be tested without first learning about the risks and possible benefits of testing and treatment.
Starting at age 50, men should talk to a health care provider about the pros and cons of testing so they can decide if testing is the right choice for them.
African American men or men who have a father or brother who had prostate cancer before age 65, should have this talk with a health care provider starting at age 45. Men who decide to be tested should get a PSA blood test with or without a rectal exam. How often they’re tested will depend on their PSA level.
This article is reprinted from H.O.P.E. Lifeline (February, 2017) - monthly newsletter distributed by H.O.P.E. Click here to view the full newsletter. If you would like to receive the newsletter by e-mail each month, you may subscribe today (no cost or obligation and you may unsubscribe at any time).