Over the past several decades, long-term cancer survival rates have been on the rise.1 These improved outcomes are largely credited to screening measures for certain types of cancers.
In general, cancer that can be detected and treated in its earliest stages, prior to any spread—and often prior to any symptoms—is associated with dramatically higher long-term survival than cancer that is treated once it has spread from its site of origin.2 As a result, screening for common types of cancers gives patients the best chances for early detection and effective treatment, which allow for the best chances for survival. People at a high risk of developing a specific type of cancer may also undergo frequent screening for that type.
The bottom line in any circumstance is that getting screened for cancer can save your life.
Christine Murar is forever thankful that her doctor insisted she undergo a screening sigmoidoscopy when she turned 50. Like many women her age, Christine was dragging her feet when she was due for the routine procedure. Fortunately, after she came up with several excuses, her doctor insisted that the procedure no longer be delayed.
It turned out that she was screened just in time. During her sigmoidoscopy, Christine’s physician found and removed polyps, which prompted a subsequent colonoscopy. During the colonoscopy, the physician found five more polyps, one of which was cancerous. Luckily, the cancer was confined to the polyp and was completely removed during the colonoscopy. Had she waited to undergo the initial screening, the cancer would have spread.
Seven years later Christine remains cancer-free and has thanked her physician for insisting that she receive the routine screening. “I told him that he saved my life.” Furthermore, because the cancer was completely removed during the procedure, Christine required no further treatment following the colonoscopy.
The National Cancer Institute (NCI) and the National Comprehensive Cancer Network (NCCN) have published guidelines for the screening of some of the most common types of cancers in the general public. These screening measures are based on extensive data, which indicates that following recommended screening measures and schedules results in improved outcomes.
Insurance often pays for these screenings, at least in part, and public health measures have been implemented to offer screening for individuals who do not have insurance or cannot afford a screening.
People who are known to be at a high risk of developing specific types of cancers may also undergo screening for that type. They should discuss their situation with their healthcare provider.
The NCI and the NCCN have established the following guidelines for the screening of common cancers among women:
Breast cancer is diagnosed in approximately 211,000 women annually in the United States, with approximately 40,000 deaths per year attributed to the disease.3
Clinical breast examination. During a clinical breast exam, your healthcare provider will feel the entire breasts, underarms, and collarbone area to detect any small lumps and may gently squeeze the nipples of the breast to check for fluid. A thorough clinical breast exam is painless and may take approximately 10 minutes. If any lumps or abnormalities are found, your healthcare provider will discuss the next steps to be taken.4
Mammogram. A mammogram is a type of breast X-ray. Your physician or gynecologist can schedule an appointment for a mammogram with a radiation technician in an FDA-approved mammography center. The results from the procedure are read by a radiologist, an expert in deciphering images from scans or tests such as X-rays. Often a mammogram can detect cancers before they can be felt.
Periodic breast self-exams. A breast self-exam (BSE) involves feeling both breasts and underarm areas for small lumps or abnormalities. It also includes looking at your breasts in the mirror to detect any abnormalities such as dimpling, swelling, rashes, or a change in size on one side and not the other.
Approximately 4,000 women die annually from cervical cancer in the United States; this is a 70 percent reduction in deaths since the introduction of the Papanicolaou (Pap) test.5
Pap test. The Pap test is the standard screening procedure for cervical cancer. The test involves the collection of a sample of cells from the surface of the cervix, which is situated at the lower end of the uterus. For screening purposes a Pap test is generally performed by your regular healthcare provider during a physical examination. The sample collected is evaluated in a laboratory for cancerous or precancerous cells as well as for the human papillomavirus (HPV). Your physician will contact you regarding the results of your Pap test.
Colorectal cancer is the second-leading cause of cancer-related deaths in the United States every year.7 Patient compliance with screening measures for colorectal cancer remains low because patients may perceive the procedures as invasive.1 Colorectal cancer does, however, have high cure rates if detected and treated in its earliest stages.
There are four general screening tests for colorectal cancer, although a colonoscopy is the preferred screening method.
Colonoscopy. During a colonoscopy a lighted tube is inserted into the rectum and through the entire large intestine. The physician performing the procedure can visualize the colon on a monitor screen. Patients receive a laxative the day before and are gently sedated for the procedure. Your general healthcare provider can either perform the procedure or refer you to another physician.
Sigmoidoscopy. During a sigmoidoscopy a lighted tube is inserted into the rectum and through the lower part of the large intestine. Patients may receive a laxative the day before and require no sedation for the procedure. Your healthcare provider may either perform the sigmoidoscopy or refer you to another physician. Often a sigmoidoscopy can be performed during a routine physical examination in the office.
Fecal occult blood test. A fecal occult blood test (FOBT) detects small amounts of blood in the stool. An FOBT may be performed from home, where a small scraping of stool is placed in a sterile container, which can be sent to or dropped off at your physician’s office. Your doctor will provide you with the packaging and the instructions.
Double-contrast barium enema. This procedure involves an enema consisting of barium that allows abnormalities within the large intestine to show up on an X-ray.
There are three main types of skin cancer: melanoma, basal cell, and squamous cell. Melanoma is by far the most deadly and aggressive type of skin cancer, whereas basal cell and squamous cell carcinomas do not tend to spread quickly.
Skin self-checks. Individuals should perform a monthly skin check on themselves or with the help of a spouse or other partner. Standing in front of two mirrors, check both sides of the body for any changes in moles or abnormalities on the skin. It may be helpful to use a handheld mirror to check areas that are difficult to examine, such as the soles of the feet and the backs of the thighs.
Remember the ABCD rule when evaluating moles during a skin exam:
If you find any changes, irregularities, or fast-growing moles or are concerned about an area on your skin, contact your healthcare provider or a dermatologist for further examination.
Clinical skin examination. Your healthcare provider may perform a skin examination during a regular clinical exam.9
All women should speak with their usual healthcare provider regarding screening measures for cancer. Your healthcare provider will help guide you with the appropriate information, referrals, and scheduling if necessary to fulfill standard screening guidelines. It is important to discuss with your physician your family history and other illnesses you have so that your risk for certain cancers can be accurately assessed. If you are at an increased risk for the development of any type of cancer, screening guidelines will be individualized to provide added measures to detect these cancers in their earliest stages.
2 Cancer Trends Progress Report—Early Detection. National Cancer Institute Web site. Available at http://progressreport.cancer.gov/doc.asp?pid=1&did=2005&mid=vcol&chid=22. Accessed June 19, 2006.
3 Overview: Breast Cancer. American Cancer Society Web site. Available at: http://www.cancer.org/docroot/CRI/content/CRI_2_2_1X_How_many_people_get_breast_cancer_5.asp?sitearea. Accessed June 19, 2006.
4 Breast Cancer Screening and Diagnosis Guidelines. National Comprehensive Cancer Network Web site. Available at: http://www.nccn.org/professionals/physician_gls/PDF/breast-screening.pdf. Accessed June 19, 2006.
5 Cervical Screening PDQ.® National Cancer Institute Web site. Available at: http://www.cancer.gov/cancertopics/pdq/screening/cervical/HealthProfessional/page2. Accessed June 19, 2006.
6 Cervical Cancer Screening. National Comprehensive Cancer Network Web site. Available at: http://www.nccn.org/professionals/physician_gls/PDF/cervical_screening.pdf. Accessed June 19, 2006.
7 General Information on Colorectal Cancer. National Cancer Institute Web site. Available at: http://www.cancer.gov/cancertopics/pdq/screening/colorectal/Patient/page2. Accessed June 19, 2006.
8 Colorectal Cancer Screening. National Comprehensive Cancer Network Web site. Available at: http://www.nccn.org/professionals/physician_gls/PDF/colorectal_screening.pdf. Accessed June 19, 2006.
9 How Is Melanoma Skin Cancer Found? American Cancer Society Web site. Available at: http://www.cancer.org/docroot/CRI/content/CRI_2_2_3X_How_is_melanoma_skin_cancer_found_50.asp?sitearea=. Accessed June 19, 2006.