Early Cancer Detection Guidelines
When cancer cannot be prevented, early detection of the disease provides the greatest opportunity for survival. Guidelines have been established for individuals at average risk for cancer who do not have specific symptoms. People who are at an increased risk for certain cancers may need to follow a different screening schedule, including starting at an earlier age or being screened more frequently. If symptoms that could be related to cancer are detected, individuals should see their doctor or health care provider immediately.
Breast Cancer
Breast cancer is the most common type of cancer in American women. According to the American Cancer Society, in 2005 an estimated 211,240 women and almost 1,700 men were diagnosed with invasive breast cancer. An additional 59,000 women will learn they have in situ or noninvasive breast cancer. Current screening recommendations include:
- Yearly mammograms starting at age 40 and continuing for as long as a woman is in good health.
- Yearly clinical breast examination (CBE) by a health care provider for women 40 and older and approximately every three years for women in their 20's and 30's.
- Breast self-exam (BSE) is an option for all women starting in their 20's. Any breast change should be reported to their health care provider promptly.
- Women at increased risk (e.g., family history, genetic tendency, past breast cancer) should discuss the frequency and type of screening exams most appropriate for their situation. This may include starting mammography screening earlier than age 40, having additional tests (e.g., breast ultrasound or MRI) or more frequent breast examinations.
Prostate Cancer
Prostate cancer is the most common cancer (excluding certain types of skin cancer) in men in the United States affecting approximately 232,090 men in 2005. It is the second leading cause of death with more than 30,000 men expected to die of prostate cancer this year. Screening tests for prostate cancer include:
- Beginning at age 50, both the prostate-specific antigen (PSA) and digital rectal examination (DRE) should be performed yearly to men who have at least a 10-year life expectancy
- High risk men should begin yearly testing at age 45. This includes: African-American men and men who have had a father and/or brothers diagnosed at an early age
Colon and Rectal Cancer
According to the American Cancer Society, an estimated 145,380 new cases of colorectal cancer were diagnosed in 2005 and more than 56,000 men and women will died from this disease. It is the third leading cause of death among men and women alike.
Beginning at age 50, both men and women at average risk* for developing colorectal cancer should follow a regular testing schedule. Some testing options include:
- Yearly fecal occult blood test (FOBT—performed on 3 successive stool specimens while the individual adheres to a prescribed diet)
- or fecal immunochemical test (FIT)
PLUS flexible sigmoidoscopy (flexible tube inserted into the anus allowing the physician to view the lower one-third of the colon) every 5 years.
- Double-contrast barium enema every 5 years
- Colonoscopy every 10 years
- Virtual colonoscopy (examines the entire colon and rectal passages by a CT scan of the abdomen that allows the radiologist to create computer images similar to those seen by a standard colonoscopy. Although this test is able to visualize the colon, polyps cannot be removed or biopsied using this technique.)
ALL positive tests should be followed up with a standard colonoscopy.
- Earlier and/or more frequent colorectal cancer screening should take place for people with colorectal cancer risk factors including:
- Personal or family history of colorectal cancer or adenomatous polyps
- Personal history of chronic inflammatory bowel disease
- Family history of hereditary colorectal cancer syndrome (familial adenomatous polyposis (FAP) or hereditary non-polyposis colon cancer (HNPCC))
Cervical Cancer
The American Cancer Society estimates there were approximately 10,300 newly diagnosed cases of invasive cervical cancer in 2005 and that almost 3,700 women died from this disease. When found and treated early, cervical cancer can often be cured. Screening recommendations include:
- All women should begin approximately 3 years after they begin having vaginal intercourse, but no later than when they are 21 years old. Screening may be conducted yearly with the regular PAP test or every 2 years using the newer liquid-based PAP test.
- Beginning at age 30, women who have had 3 normal PAP test results in a row may be screened every 2 to 3 years although women with certain risk factors (diethylstilbestrol (DES) exposure before birth, HIV infection or a weakened immune system) should be screened once a year.
- Women 70 years of age or older who have had 3 or more normal PAP tests in a row and no abnormal PAP test results in the last 10 years may choose to stop having this screening. Women with a history of cervical cancer, DES exposure before birth, HIV infection or a weakened immune system should continue with yearly screening as long as they are in good health.
- Women who have had a total hysterectomy (removal of the uterus and cervix) may choose to stop having cervical cancer screening unless surgery was done as a treatment for cervical cancer or pre-cancer. Women who have had a hysterectomy without removal of the cervix should continue to follow the guidelines above.
Endometrial (Uterine) Cancer
According to the American Cancer Society, uterine cancer is the most common type of gynecologic cancer with an estimated 40,880 new cases in 2005.
Women are strongly urged to report any unexpected bleeding or spotting to their health care provider. For women with or at high risk for hereditary non-polyposis colon cancer (HNPCC) annual screening should be offered for endometrial cancer with endometrial biopsy beginning at age 35.
Skin Cancer
Skin cancers are the most common occurring cancers accounting for more than 50% of all cancers, according to the American Cancer Society. More than 1 million cases of non-melanoma skin cancers occur every year. Skin cancer can be detected early by regular skin checks. Particular attention should be paid to new marks or moles on the skin and any changes that have taken place in these areas. The American Cancer Society guidelines can help distinguish a normal mole from a potential melanoma.
This "ABCD rule" is as follows:
- Asymmetry: the two halves of a mole do not match
- Border Irregularity: the edges of the mole are uneven
- Color: differing shades of red, brown or black within a mole. Sometimes patches of white, blue or red may also appear. Changes in the color of a mole are also cause for further evaluation
- Diameter: the mole is larger than one-quarter of an inch in width
Your skin should be examined by a doctor or health care provider at least every three years for individuals between the ages of 20 and 40 and once each year for individuals over the age of 40. More frequent examinations should take place if you have a history of skin cancer or melanoma or if changes in existing moles are seen.
