One in three women will develop some kind of cancer by age 85 -- a rate higher than the probability of getting into a car accident by that age, says Sameer Gupta, MD, MPH, hematologist-oncologist at Bryn Mawr Hospital.
Defined as the search for a disease without symptoms, a screening test typically is performed on patients without any clinical signs of disease.
"You don't want to wait to become sick to find out if you have cancer," Dr. Gupta adds.
"Majority of patients who get a cancer diagnosis say that they never had any problems, which is why screening is so important."
For women in particular, approximately 50 percent of cancers among fall into one of these four categories:
3. Colon & rectum
As the most common cancers, breast, lung and colon cancers impact more than 120,000 women a year. What's more, 50 percent of cancer mortalities in women are from these three cancers.
The good news is that mortality has been decreasing for breast and colon cancers because of cancer screenings.
Whereas it is rare to see women develop cervical cancer after age 65, Dr. Gupta explains breast cancer can present in women even in their 80s. The recommendations for women to receive breast cancer screening include:
- Yearly mammograms are recommended for women starting at age 40 and continuing as long as a woman is in good health.
- Women in their 20s and 30s should receive a clinical breast exam every 3 years.
- Women age 40 and over should receive a clinical breast exam every year.
For higher risk patients, a breast MRI is recommended. This high risk population can be defined as women with:
- BRCA gene mutations
- Prior thoracic radiation therapy (from ages 10 to 30 years)
- Other Genetic Syndromes that increase the risk of cancer
- Higher risk based on family/personal history
The National Lung Cancer Screening Trial recently reported data on use of low dose CT Scan in detecting lung cancer.
Patients at high risk for lung cancer included on this trial were 55-74 year old and had more than 30 pack-year history of smoking. The trial did include patients who had quit within the last 15 years. CT scans were shown to find more lung cancers at early stages and had an effect on survival also.
Colonoscopy is a proven screening mechanism to detect colorectal cancer.
"Recent data shows that it saves lives and has cut down the expected death rate for colon cancer down by half," Dr. Gupta says. "Colonoscopy reduces mortality because it picks up early stage cancer."
The recommendations for colorectal cancer screening include a colonoscopy at least every 10 years starting at age 50. Some people may need more frequent screening based on what is found on the initial colonoscopy. In addition, women with a family history of colon cancer at a young age may need a colonoscopy 10 years prior to the age of cancer diagnosis in the family member.
New recommendations for cervical cancer screening have recently changed stating women should begin cervical cancer screening at age 21 and not 18 as before. Below are the recommendations:
- All women should begin cervical cancer screening at age 21
- Women age 21 to 29 should undergo a Pap test every 3 years. Testing for HPV is indicated after an abnormal Pap test result.
- From age 30 to 65, women should receive both a Pap test and an HPV test every 5 years. It is also okay to have a Pap test alone every 3 years.
- Women over age 65 should not be screened for cervical cancer if they have had normal results through out their life. However, women who have been diagnosed with cervical pre-cancers should continue to be screened.
- Women who are at high risk, defined has having an HIV infection, organ transplant or exposure to the drug DES, may need more frequent screening.
Prevention Is Key
According to the American Cancer Society, cancer screening has saved approximately a quarter million lives in the last 25 years.
Still, the recommendations for when and how frequently a woman should be screened for these common cancers change often because many agencies, task forces and societies analyze the population statistics and come up with their own guidelines as a result.
Such contrasting recommendations underscore the importance of women to be proactive about their health and build a relationship with their physician.
"The cancer screening guidelines are rough recommendations based on available data, however, they are subject to interpretation," Dr. Gupta says. "Talking to your primary care physician or gynecologist is best. They can answer questions about your particular condition, family history and risk."
Above all recommendations, Dr. Gupta urges women to take care of their health, as prevention is key. Along with the proper screening test, eating well, exercising, moderating consumption of alcohol and quitting smoking all can help women maintain their health.
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