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Cancer Screening
What is cancer screening?Cancer screening refers to tests that can be done to look for signs of cancer or to see if you are likely to develop cancer. Screening tests that look for cancer are called early detection tests. Screening tests that show cancer is likely to develop are called preventive screening. An example of an early detection test is a mammogram, which can show cancerous breast tumors when they are still tiny. An example of a test that can be used for preventive screening is a Pap test. The Pap test can show cell changes likely to turn into cancer before the actual cancer has developed. Why is cancer screening important?Cancer screening saves lives and improves the quality of life for cancer survivors. There have been many advances in cancer treatment over the past few years. Cancer no longer has to be a death sentence. Early treatment often results in a cure. Many people are now living well after a cancer diagnosis, often because their cancer was diagnosed and treated very early. For example, precancerous changes found with a Pap test can easily be treated and cured before cancer develops. A small breast cancer may be seen on a mammogram up to 2 years before it can be felt with a breast exam. The cancer can then be treated early, greatly increasing the chances for survival. What are the recommended tests?Screening tests that have been shown to have benefit are:
Mammograms Most women should have a baseline mammogram between the ages of 35 and 40. They should then have a mammogram to look for changes in the breast every 1 to 2 years until age 50. After age 50 mammograms should be yearly. Women who have a personal or family history of breast cancer may need mammograms at a younger age. Pap tests Young women should have their first Pap test to screen for cervical cancer when they start having sexual intercourse or become 21. All women should have a Pap test once a year unless, after 3 Pap tests with normal results, their health care provider recommends having the test every 3 years. Fecal occult blood testing (FOBT) At age 50 men and women should start having fecal occult blood testing to screen for colon and rectal cancer. Usually your provider will give you a kit for this test. You will put a tiny sample of bowel movement from 3 different days on the cards, pads, or wipes included in the kit. Usually you will then take or mail the samples to your provider or the lab The samples will be tested for blood. If there is blood in the samples, you will need more tests. Sigmoidoscopy and colonoscopy Sigmoidoscopy and colonoscopy are procedures for looking for precancerous or cancerous changes in your colon and rectum. A slim, flexible, lighted tube is inserted into your rectum to view the inside of these organs. These tests are usually begun at age 50. Depending on your personal and family history, they may need to be repeated every 5 to 10 years. PreGen Digital Rectal Exam For this test, the health care provider puts a gloved finger in a man's rectum to feel the prostate gland. Prostate cancers feel very hard compared to normal prostate tissue. If something abnormal is felt, then you have other tests to see if there is a tumor and whether it is a type of cancer that will spread. Are there other screening tests?If breast cancer occurs often and at younger ages in your family, you may choose to have a BRCA gene test. This test can show if you have inherited a changed form of the gene that may increase your risk of breast cancer. Some women who have this changed form of the gene choose to have their breasts removed to keep from getting breast cancer. It is not yet clear if other tests are helpful. One such test is the prostate specific antigen test (PSA). The PSA level in the blood usually rises when a man has cancer of the prostate. However, it also rises if the prostate is infected or enlarged. (Prostate enlargement is common in middle age and later.) The test often gives misleading results and can cause undue anxiety, expense, and unnecessary medical procedures. For this reason, the PSA test is not recommended as a general screening test. However, because African American men have the highest rate of prostate cancer in the US, PSA may be used to screen them. Also, men who have a history of prostate cancer in their families may be screened. Research is ongoing to see when and how PSA might be helpful as a screening test for prostate cancer. How can I know when I should have screening tests?Which tests you have and the timing of these tests depend on your personal and family history. For example, if someone in your family had colon cancer before age 50, you may need to start tests for this type of cancer at an earlier age. Ask your health care provider which cancer screening tests you need and how often.
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