Cancer Screening

Cancer remains one of the most difficult diseases to treat, and one of the most intimidating diseases for patients to face. Medical science is improving rapidly in this area, and there have been major gains in treatment efficacy. However, successful treatment still relies on catching the cancer early and getting an accurate diagnosis. And early detection isn’t possible without cancer screening.

While cancer screening does not prevent the disease from forming and isn’t 100 percent accurate, it is, on the balance, an invaluable method of anticipating and mitigating the effects of some forms of the disease. Early detection often means more effective treatment, and often less of it, which can save the patient some stress, as some cancer treatments can be physically and mentally taxing. And, of course, a favorable cancer screening can provide peace of mind to the patient.

How are cancer screening tests performed?

There are more than 100 types of cancer, but only a small handful are regularly screened for. This is because screening just isn’t possible for some forms of cancer as the tests aren’t particularly accurate or because the symptoms aren’t typical of cancer. However, if a patient expresses certain risk factors, then screening should be considered. These risk factors include age, family medical history, race/ethnicity, certain behavior (like smoking), work history and the presence of other medical conditions. Physicians can also check for gene mutations, as these can greatly increase the chances of developing many varieties of cancer.

But in patients who are asymptomatic (not demonstrating any outward signs of cancer, and risk factors are minimal), then cancer screening is typically confined to targeting a few specific forms of the disease. The most common screenings are for breast cancer, cervical cancer, colon cancer, lung cancer and, depending on age, prostate cancer. The tests associated with these forms of cancer have been thoroughly developed, are quite accurate and come with few downsides. This short list also represents potentially deadly forms of the disease, making screening even more important.

What do breast, cervical, colon, lung and prostate cancer tests consist of?

1. Breast cancer screening – Women should be familiar with how their breasts normally look and feel and report any changes to their physician right away. In healthy patients with no significant family history of the disease, breast cancer screening normally begins upon turning 40, though some physicians will wait until the patient turns 45 before recommending regular mammograms.

Mammograms represent the primary form of breast cancer screening. During a mammogram, X-rays are taken of the breasts, and though the procedure can be a bit uncomfortable, as pressure must be applied to the breasts to get an accurate image, it only takes a few moments. It’s best to avoid scheduling a mammogram the week before getting your period, as your breasts may be swollen or tender, making the test particularly uncomfortable. Also, avoid wearing perfume or deodorant, as these can produce image artifacts on the X-rays.

The images are sent to a radiologist for review, and results normally come back within a few weeks. If there are any abnormalities on the image, further testing may be required. If additional testing is needed, or if the patient’s breasts are particularly dense or at a high risk of developing cancer, the physician may schedule an MRI for a closer look. MRIs are rarely administered to patients with an average risk of breast cancer.

2. Cervical cancer – Cervical cancer screening is recommended in women as young as 21 years old, as it can be easily treated with early detection. The tests associated with cervical cancer rarely produce complications and can be used to detect a number of issues, so they are a valuable source of information.

Starting at 21 years old, women should undergo a Pap test (or Pap smear) every three years. Upon turning 30, women only need a Pap test every five years, assuming they have showed no risk factors previously. Following a hysterectomy that also removes the cervix, testing is no longer required, as long as the hysterectomy wasn’t performed in response to cervical cancer.

During a Pap test, the physician will use a speculum to widen the vagina. The doctor will examine the vagina and cervix during this time, and will collect cells and mucus from the cervix for testing. The sample is sent to a laboratory for examination under a microscope, with the goal of checking for any abnormal cells. Results are sent back within a few weeks, and if there are abnormalities, an exam for HPV (human papillomavirus) will usually be recommended. An HPV test is performed much like a Pap test and may be performed during a Pap test to rule out both conditions.

Fortunately, an abnormal Pap test usually means something other than cervical cancer, and the patient’s healthcare provider can help discover the cause.

3. Colon cancer – Starting at 50 years old, both men and women should begin screening for colon cancer. Testing specifics, including the preferred method and testing frequency are usually discussed between the patient and their healthcare provider, and a screening plan put in place.

Some patients may need to start screening sooner. This includes people who have a close relative who developed the disease, people with inflammatory bowel disease (Crohn’s and ulcerative colitis, for example) and people with certain genetic syndromes.

There are several methods of colon cancer screening. Colonoscopy is the most common and is performed with a flexible tube that is inserted into the rectum and sends images back to the doctor. The entire colon can be examined for cancer or polyps using this method. An alternative to the colonoscopy is the sigmoidoscopy, though this can only be used to check the lower colon.

Fecal tests, including the fecal occult blood test (FOBT) and DNA tests of the feces can check for polyps or cancer using abnormalities discovered in the stool.

4. Lung cancer – Lung cancer screening is typically only recommended for patients who have a history of smoking but can also be warranted for those that have been exposed to asbestos. People who have a history of smoking or asbestos exposure and are between 55 and 80 years of age should undergo annual lung cancer screening. The only exception to this is if the patient quit smoking more than 15 years ago.

There is only one lung cancer test that is recommended, and that’s low-dose computed tomography, or CT scans. During a CT scan, the patient lies on a table that is wheeled into the scanner. It’s painless and over fairly quickly. The images are combined to create sophisticated cross-sectional views that give radiologists a clear picture of the lungs. Most abnormalities can be caught through a CT scan.

However, CT scans do expose the lungs to low doses of radiation, so they are not recommended for people who do not have a history of smoking. CT scans can also produce false positives and may find something that is not a significant threat to the patient, so if an abnormality is detected, further examination will be needed before opting for treatment.

5. Prostate cancer – Prostate cancer screening is only recommended for men who are at least 40 years old and men with notable risk factors. This includes African American men and men who have immediate family members who developed prostate cancer before the age of 65.

The classic form of prostate cancer screening is the digital rectal examination, or DRE. During the DRE, the doctor inserts a gloved, lubricated finger into the rectum and physically examines the prostate for any irregularities.

Although other forms of cancer can be screened for, including ovarian, pancreatic, testicular and thyroid, these tests are typically only recommended in rare cases, where the patient is at an extremely high risk of developing the disease.

Cancer screening won’t prevent cancer, but it is the first line of defense against the disease. A patient’s chances of defeating cancer improve greatly if it is found early, so cancer screening is a valuable tool in potentially preserving life.