As a family physician I am always asked the question “Can we do a blood test to check for cancer?” Unfortunately there is no one blood test that will tell you this information …Well not yet of course. However there are a variety of cancer screenings that we do recommend. I will review the major ones, but please contact your health professional for more information and questions as well as remember that we as physicians go on a case-by-case basis in many instances. Below are just the guidelines given by different sources that we as physicians refer to.
Colon Cancer Screening :
- The U.S Preventative Services Task Force (USPSTF) recommends screening colorectal cancer using fecal occult blood testing, sigmoidoscopy, or colonoscopy in adults, beginning at age 50 years and continuing until age 75 years.https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/colorectal-cancer-screening
- A colonoscopy is a procedure that is done by a gastroenterologist. Once you get this procedure to have the specialist look into your colon for evidence of polyps or cancerous cells. If it is normal you can repeat this in 10 years. If it is abnormal (polyps) then depending on the results the specialist will give you follow up guidelines.
- Fecal occult blood testing is done on a yearly basis tests for blood in the stool. If it is positive you will proceed for a colonoscopy. If it is negative you will repeat this the following year.
- Sigmoidoscopy which I personally don’t refer to looks the lower 20 inches of a persons sigmoid colon and rectum. In my practice I either proceed with colonoscopy or FIT card.
Breast Cancer Screening:
The USPSTF recommend biennial screening of women 50 to 75 years old.
You may ask what about prior prior to 50 years of age? It should be evaluated on an individual basis. .
Of note, women with a parent, sibling, or child with breast cancer are at higher risk for breast cancer and thus may benefit more than average-risk women from beginning screening in their 40s. For more details go to the link below: https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast-cancer-screening1
ACOG (American College of Obstetricians and Gynecologists)
- Recommends the following that women at average risk of breast cancer should be offered screening mammography starting at age 40 years.
- This is a case by case discussion with your doctor weighing the risks and benefits.
- Screening should take place until age 75. Also beyond 75 years old, the decision to discontinue should be case to case.
- For more details link is here in terms of ACOG recommendations. https://www.acog.org/About-ACOG/News-Room/News-Releases/2017/ACOG-Revises-Breast-Cancer-Screening-Guidance–ObGyns-Promote-Shared-Decision-Making?IsMobileSet=false
Cervical Cancer Screening
- The USPSTF and ACOG recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years.
- For women aged 30 to 65 years, the USPSTF and ACOG recommends screening every 3 years with cervical cytology alone, every 5 years with high-risk human papillomavirus (hrHPV) testing alone, or every 5 years with hrHPV testing in combination with cytology (co-testing).
- The USPSTF and ACOG recommends against screening for cervical cancer in women younger than 21 years.
- The USPSTF and ACOG recommends against screening for cervical cancer in women who have had a hysterectomy with removal of the cervix and do not have a history of a cancer.
- If history of cancer it is important to continue pap smears.
Lung Cancer Screening
- The USPSTF recommends annual screening for lung cancer with low-dose CT Scan in adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years.
- Screening should be stopped once a person has not smoked for 15 years
- Screening should be stopped it person develops a health problem that limits life expectancy or the ability to have lung surgery that will lead to a cure.
Prostate Cancer Screening
- USPSTF States that men ages 55 to 69 years, the decision to undergo prostate-specific antigen (PSA)–based screening for prostate cancer should be an individual one.
- Usually I discuss the potential risks and benefits of screening with my patients.
- Screening offers a small potential benefit of reducing the chance of death from prostate cancer in some men.
- Some of the harms of screening is additional testing and possible prostate biopsy with false positive results. with that over diagnosis and sometimes over treatment can occur.
- You may ask what are some complications of this? This includes incontinence and erectile dysfunction.
These are a few of the main cancer screenings that we do as mentioned above. I included the links that pertain to these guidelines. Of course these are the recommendations and guidelines, but every patient is addressed individually from a case to case basis. Please refer to your physician for any questions you may have.