April 01, 2008
Joan Marie Pellegrini, MD
Happy April Fool’s Day. This is a good time not to let yourself be fooled. One good way to do this is to reassess where you stand in terms of cancer screening. If you are over 20, you should start with an annual or every other year health exam that would look for cancers of the thyroid, lymph nodes, testes and ovaries, and skin. The following recommendations are for people of average risk and are listed by body site.
Breast: yearly mammogram starting at age 40. Self breast exam starting in your 20’s so that you become familiar with how your breasts should feel.
Colon and rectum: Colonoscopy at age 50 and every 10 years of normal. Colonoscopy more frequently depending on what is found. Your doctor will also order fecal occult blood (look for nonvisible blood in the stool) every year.
Cervix: All women should have a PAP smear every 1-2 years starting around age 21. Women older than 30 who have had 3 normal PAP smears in a row, may be eligible for screening only every 3 years.
Uterus: Any women who has gone through menopause needs to report any bleeding to their primary care provider.
Prostate: Men over the age of 50 who are expected to live more than 10 more years should have a rectal exam and a PSA (blood test screen for prostate cancer). A PSA should not be checked within several weeks of a rectal exam, any urethral trauma, a bladder catheter insertion because this will lead to falsely elevated levels.
An annual exam may also screen for other cancers such as skin, kidney (urinalysis), lung (chest xray), esophagus (endoscopy), etc depending on your risk factors and family history.
You may access these recommendations at www.cancer.org. The American Cancer Society also hase cancer facts and figures on their webpage.
One must also remember that for a test to be recommended for screening a large population in general, it must be shown to be safe (not have a high incidence of harm), effective (be able to find the cancer for which we are searching), and cost effective (save the patient or society money in the long run by finding cancer in its early stages). All of the above tests meet these guidelines.