Screening, in health care, is a process of testing for an unrecognized disease or illness in asymptomatic individuals with the goal of early intervention and management and thus reducing mortality and suffering. a negative aspect associated with any screening test is that it may lead to unnecessary tests and interventions, which may harm an individual, defeating the original purpose of the test. Screening for common cancers such as breast, cervical, and colorectal cancer has shown improved outcomes with early detection. the following is a guideline of when, where and how to screen for these different cancers:
- Breast: it is recommended to assess lifetime risk using a breast cancer risk assessment tool such as the Gail model, available at cancer.gov/bcrisktool. For those with less than 15 percent risk, and for those between 15-20 percent: a mammogram with or without a clinical breast exam at ages 50-69 is recommended, with a clinical breast exam (cbe) every 3 years starting from ages 20-39 and annually thereafter per the American Cancer Society. those with greater than 20 percent risk: refer to genetic counseling to determine the likelihood of BRCA mutation and management options and starting at age 25, mammogram and breast MRI with a clinical breast exam
- Colorectal: adults age 50 and older with the common test such as colonoscopy
- Cervical: cervical cytology and HPV testing are recommended for ages 21-65 in sexually active women with a cervix, with earlier testing for women with HIV infection, lupus or organ transplant on long-term immunosuppression therapy
- Skin: adolescents and young adults ages 10-24 with fair skin and at high risk for skin cancer should have a baseline skin exam by a trained physician and subsequent exam every 6 months until mole remains stable and an annual exam thereafter
- Prostate: PSA screening with Digital rectal examination is recommended for men age 50 and older
- Ovarian: Screening with a blood test and pelvic ultrasound is appropriate for women with a positive family history of ovarian and breast cancer, recommended at about age 30-35
As a rule of thumb, if you have a positive family history of any of these types of cancer, you should screen 10 years earlier than the age of onset in your relative. If you have any questions, please contact our office for further details.
