Cancer Screenings 101
Dr. Nancy Simpkins gives the who, what and when of cancer prevention.
An estimated 1,685,210 new cancer cases were diagnosed last year, and over 500,000 people died of the disease, according to the National Cancer Institute. Their study also found that breast, lung, prostate, colon and rectal cancers were the most common. The statistics are scary, but there are things you can do to protect yourself. Here's how to figure out which screenings to get and when to get them.
1. Breast Cancer Screenings
If there is no history of breast cancer in your family and you have had normal breast exams at your doctor, your baseline mammogram should be at age 40. If there is a strong family history (meaning your mom or sister has been diagnosed) then screening should begin earlier, as discussed with your doctor. Not all breast cancers are hereditary, but it is important to discuss with your doctor. The way to properly screen for breast cancer is currently under review by the American College of Radiology. There is an ongoing controversy about whether dense breasts (with less fatty tissue) are more prone to breast cancer. In 2017, women who are found to have dense breast tissue on mammograms might be asked to return for an ultrasound or MRI to assess breast tissue more closely. Women under 40 should have yearly breast exams at their gynecologist or internist, and if you find lumps on your own, tell your doctor.
2. Cervical Cancer Screenings
When seeing your gynecologist for an annual exam, they will perform a pelvic exam and do a PAP smear looking for abnormal cervical cells. Cervical cancer is a preventable disease thanks to yearly or biyearly pap smears and the HPV vaccination. Most young women are vaccinated against the HPV virus, which is responsible for over 90 percent of cervical cancers. There are four stages doctors use to grade pap smears ranging from normal (stage 1) to atypical (stage 2 and 3) to cancer (stage 4). The good news is that, if you have frequent screenings, your doctor can find and remove atypical cervical cells before they become cancerous.
3. Colon Cancer Screenings
These typically begin when you're around 50 with a screening colonoscopy. On a personal practice note, I start doing non-invasive, at-home colon cancer screening tests for patients starting at age 35. The test, called hemoccult cards, can easily be done at home and yields a great deal of information. I have started to see colon cancer in younger and younger patients over the years, perhaps due to diet, so I feel more comfortable starting the testing earlier than 50. If the at-home tests are negative every year, you can safely wait to have a colonoscopy until you're 50.
4. Thyroid Cancer Screenings
During your yearly physical exam at either your gynecologist or internist, they will palpate your neck and feel your thyroid gland. The thyroid gland controls metabolism. Although most diseases of the thyroid are benign, thyroid cancer is a disease of young people and one that is easily curable if detected early. If your doctor notices a nodule in your neck, or you notice anything abnormal, a simple ultrasound can confirm the nature of the nodule.
5. Skin Cancer Screening
Skin cancer is often one that we forget about screening. It's important to schedule an annual at the dermatologist to determine if any of your moles are “normal” or “not normal." Of course, sunscreen is your first line of defense. Melanoma is a disease of young people and is hereditary, so if your mom or dad has had malignant melanoma, start your skin checks yearly at age 30.
6. Lymphoma Screenings
Both Hodgkin's and non-Hodgkin's lymphoma is associated with young people. Doctors don't routinely screen for it, because it has symptoms, like swollen lymph nodes, fatigue, night sweats, etc. It is always a good idea to discuss any new symptoms or physical findings with your doctor. There are many preventative measures that can be taken to prevent the development of cancer. Lifestyle is key—eat healthy (avoid saturated fat and red meat), exercise, wear sunscreen and don't smoke. And see your doctor yearly to discuss prevention with her!
For more from Dr. Nancy Simpkins, read her recent columns on the site or visit her online.