Dr Pamela Prince Pyle

Should You be Screened for Cancer?

It was this time of year in 2019 that a storm was brewing and we went blissfully unaware through football season, holidays, and a new year with new hopes and dreams. This storm became a pandemic and the life of every person was affected throughout the world. We could not have imagined the toll that would be taken on human life and human’s living.

During this time we spoke of disease only through the lens of Covid and yet, every day people died from heart attacks, strokes, infections, and cancer. They often died alone. Also, during this time access to routine health screening, including cancer screening became non-existent as fear kept people home and doctors were stretched too thin.

The world took a collective sigh as life in a pandemic seemed to be in our rearview mirror. Yet, the effects remain with us and their impact remains unknown. One of these effects is cancer previously detected at early stages went unchecked and those faithful to their screening regiment have failed to return to preventive care.

If this is you, or if you are not sure where to begin, read on for determining if you should be screened for cancer. It could mean the difference between life or death. Haven’t we had enough death?

These guidelines are from the American Cancer Society [i] and are meant for those at average risk. If you have a family history of cancer, risk behaviors for cancer, or just don’t know, take the time to see your doctor and come prepared with your questions written down.

Breast Cancer

  • Self-examination should be done regularly and concerns brought to your clinician
  • Age 40 – 44: Annual mammograms are considered optional and should be discussed with your clinician.
  • Age 45 – 54: Annual mammograms
  • Age 55 and older: Mammograms should be continued at a minimum of every two years, although annual exams can be continued. This regiment should continue for as long as a woman is healthy and expected to survive for ten years.
  • If you are unsure if you are at increased risk for breast cancer, it is crucial to ask your clinician. There are many lifestyle factors that may increase your risk of breast cancer and consideration for changing them while young should be made. You can find these risk mitigation changes here. There are also many risk factors for breast cancer that cannot be changed. Understanding if you are at increased risk is important and can be found here.

Cervical Cancer

  • Begin screening at age 25. You should be screened if you have a cervix. A Primary Human Papilloma Virus (HPV) test should be performed every five years. If a Primary HPV screening test is not available, a co-test (HPV and Pap Smear) can be done every five years, or a Pap Smear every three years. This schedule should continue until the age of 65 and ten years of normal tests. If you have had a pre-cancerous lesion, screening should continue for twenty-five years after that result. All screening should be completed regardless of HPV vaccination status.
  • Many are at increased risk for cervical cancer and therefore evaluating your risk with your clinician is crucial.

Endometrial Cancer

  • Risk factors should be discussed with your doctor at the time of menopause.
  • Post-menopausal vaginal bleeding should be immediately reported to your clinician.

Colon and Rectal Cancer

  • Screening can be done by stool studies or visual exam and should be done on a regular schedule beginning at the age of 45 if you are at average risk and continue to the age of 75. Screening between 75 and 85 is based on preference and health status and should be discussed with your clinician. Visit your clinician if you have a family history of colon cancer to determine if you should be screened at an earlier age.
  • Visual tests
    • Colonoscopy every ten years
    • Virtual colonoscopy via CT Colonography every five years
    • Flexible Sigmoidoscopy every five years
  • Stool-based tests
    • Highly sensitive fecal immunochemical test (FIT) every year
    • Highly sensitive guaiac-based fecal occult blood test (gFOBT) every year
    • Multi-targeted stool DNA test (mt-sDNA) every 3 years

Lung Cancer

  • Annual lung cancer screening should be done for anyone 50 to 80 who smokes or quit smoking in the preceding 15 years and has a 20 pack-year smoking history (1 pack per day for 20 years, two packs a day for ten years, etc.) Current recommendations for screening are a low-dose CT scan.

Prostate Cancer

  • The risk-benefit ratio of prostate cancer should be discussed with your doctor
  • This should be done at the age of 50 unless you are African American or have a family history of prostate cancer before the age of 65, in which case this discussion of the pros and cons should be done at 45. This discussion should take place at the age of 40 if you have more than one family member who has had prostate cancer before the age of 65.

It is important to note that these guidelines are current as of October 2023, however, guidelines for cancer screening can change as more research is completed. Therefore, the best plan of action is becoming your own health advocate and evaluate the guidelines regularly at www.cancer.org and with your clinician.

[i] Find cancer early. American Cancer Society. (n.d.). Retrieved October 13, 2023, from https://www.cancer.org/healthy/find-cancer-early.html 

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