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  • Cancer Tests That Can Save Your Life

    Image for cancer tests The American Cancer Society (ACS) offers these general screening recommendations for healthy women. If you have certain risk factors or symptoms, work with your doctor, who can create a cancer screening schedule that is right for you. It is important to remember that people of any age can get cancer, but the risk for most cancers increase with age.
    The following is advice from ACS on how to watch for common cancers in young and middle-aged women. Since screening tests and exams are the best way to catch cancer early, carefully check to make sure you are getting what you need.

    Breast Cancer

    In women, breast cancer is the most common cancer other than skin cancer. It is also one of the leading causes of cancer deaths in women.

    Screening Tests

    The ACS recommends the following screening tests for breast cancer:
    • Breast self-exam (BSE)—This is an option for women beginning in their 20s. This is a step-by-step examination of your breasts that you do yourself. It is one tool that can be used to help detect changes in your breasts that may or may not be a sign of cancer. You should understand that the self-exam has limits, benefits, and potential harms. You should discuss this with your doctor and decide if doing regular breast self-exams are right for you. In general, you should be familiar with how your breasts look and report any changes or anything abnormal to your doctor.
    • Clinical breast exam (CBE)—During this exam, the doctor checks for suspicious lumps or other changes in your breasts. If you are in your 20s or 30s, you should have a CBE at least every three years. If you are aged 40 or older, you should have CBE every year.
    • Mammograms—This exam uses low-dose x-rays to make a picture of your breast tissue. The ACS recommends having a mammogram every year starting at age 40. You can continue to have this exam yearly if you are in good health. Due to family history, genetics, or other factors, some women may also want to have an MRI in addition to mammograms. Your doctor can help you decide if additional screening is recommended for you.

    Cervical Cancer

    Thanks to widespread screening with Pap smears, cervical cancer has declined over the past 30 years. This type of cancer is usually found in women aged 50 or younger, but it can occur at any age.

    Screening Tests

    The ACS and many other health organizations recommend the following guidelines for cervical cancer screening:
    • If you are aged 21-29 years—It is recommended that you have the Pap test every three years.
    • If you are aged 30-65—It is recommended that you have the Pap test along with the human papillomavirus (HPV) test every five years. (Or, you can continue to have just the Pap test every three years.)
    • If you are aged 65 or older—You may be able to stop having Pap and HPV tests if you have had normal results (eg, three normal results in a row and no abnormal results in the past 10 years).

    Ovarian Cancer

    Ovarian cancer is another common type of cancer affecting the female reproductive organs.

    Screening Tests

    There are not currently effective tests for early detection of ovarian cancer. You should let your doctor know if you have any symptoms that may be caused by ovarian cancer such as bloating, belly or pelvic pain, feeling full early, or problems urinating. Remember that these symptoms may have other causes than ovarian cancer.
    If you are at high risk for ovarian cancer, there are some screening tests that may be used, such as pelvic exams, transvaginal sonography (a type of ultrasound test) and CA-125 blood test (a protein that may be higher in women with ovarian cancer).

    Endometrial Cancer (Uterine Cancer)

    Endometrial cancer affects the inner lining of the uterus (called the endometrium).

    Screening Tests

    ACS recommends that you talk to your doctor about the risks and symptoms of endometrial cancer, especially once you reach menopause (usually around the age of 50). If you have any symptoms (eg, vaginal bleeding or spotting, pain in the pelvic area, pain during urination or intercourse), tell your doctor right away. If you are at high risk for endometrial cancer, after age 35 you may need to have an endometrial biopsy every year.

    Skin Cancer

    Skin cancer is the most frequent kind of cancer in the US. The vast majority of skin cancers are basal cell or squamous cell carcinoma. Melanoma is a less common type that can be much more deadly.

    Screening Tests

    During your routine physical exam, your doctor will check your skin. If you have any concerns about suspicious moles, talk to your doctor. Some symptoms to look for include changes in the shape (eg, uneven shape or ragged edges), color, or texture of a mole. You can also check your skin once a month. Follow these tips for doing a skin self-exam:
    • Use a full-length mirror or hand-held mirror to check hard to spot places, such as between the buttocks or in the genital area.
    • Do the exam in a well-lit room.
    • Turn from front to back and left to right.
    • Note the size, shape, color, and texture of all skin blemishes and moles.
    • Check your fingernails, palms, and forearms.
    • Check your feet, toenails, soles, and between the toes.
    • Examine your scalp, separating the hair with a comb or a blow dryer.

    Colorectal Cancer

    Colorectal cancer affects the colon or the rectum, which are parts of the digestive system.

    Screening Tests

    According to the ACS, you should begin screening at age 50. If you have certain risk factors for colorectal cancer, you may need having screening tests started when you are younger. Screening may involve one of the following tests:
      Tests to find polyps and cancer:
      • Flexible sigmoidoscopy (every 5 years)—a visual exam of the rectum and lower portion of the colon
      • Colonoscopy (every 10 years)—a visual exam of the rectum and colon.
      • Double-contrast barium enema (every 5 years)—a test that involves inserting barium (a milky fluid), and then having x-rays done of the intestines
      • CT colonography (every 5 years)—a radiology test that looks at the colon
      Other tests that may be used to find cancer:
      • Fecal occult blood (every year)—a test to detect the presence of blood in the stool
      • Fecal immunochemical test (every year)—another test to detect the presence of blood in the stool
      • Stool DNA test (no specified schedule)—a test to identify DNA markers that may signify the presence of polyps or cancer
    While these recommendations are from the ACS, there are many other organizations that provide screening guidelines. The screening tests that your doctor recommends depend on a number of factors, like your age, personal and family medical history, risk factors, and symptoms. You can take an active role in your healthcare by talking to your doctor about the right screening tests for you.

    RESOURCES

    American Cancer Society http://www.cancer.org/

    National Cancer Institute http://www.nci.nih.gov/

    CANADIAN RESOURCES

    BC Cancer Agency http://www.bccancer.bc.ca/

    Canadian Cancer Society http://www.cancer.ca/

    References

    American Cancer Society guidelines for the early detection of cancer. American Cancer Society website. Available at: http://www.cancer.org/docroot/PED/content/PED%5F2%5F3X%5FACS%5FCancer%5FDetection%5FGuidelines%5F36.asp?sitearea=PED. Updated July 6, 2010. Accessed March 14,2011.

    Barium enema. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated October 2009. Accessed March 30, 2010.

    Breast cancer screening: research and guidelines. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated November 2009. Accessed January 19, 2010.

    Breast self-exam. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated March 2010. Accessed March 29, 2010.

    Can breast cancer be found early? American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/content/CRI%5F2%5F4%5F3X%5FCan%5Fbreast%5Fcancer%5Fbe%5Ffound%5Fearly%5F5.asp?sitearea= . Updated March 2010. Accessed March 29, 2010.

    Can cervical cancer be prevented? American Cancer Society website. Available at: http://www.cancer.org/Cancer/CervicalCancer/MoreInformation/CervicalCancerPreventionandEarlyDetection/cervical-cancer-prevention-and-early-detection-can-cervical-cancer-be-prevented . Updated March 14, 2012. Accessed June 5, 2012.

    Can endometrial cancer be found early? American Cancer Society website. Available at: http://www.cancer.org/Cancer/EndometrialCancer/DetailedGuide/endometrial-uterine-cancer-detection. Updated March 13, 2012. Accessed June 5, 2012.

    Can ovarian cancer be found early? American Cancer Society website. Available at: http://www.cancer.org/Cancer/OvarianCancer/DetailedGuide/ovarian-cancer-detection . Updated January 11, 2012. Accessed June 5, 2012.

    Can squamous and basal skin cancer be found early? American Cancer Society website. Available at: http://www.cancer.org/Cancer/SkinCancer-BasalandSquamousCell/DetailedGuide/skin-cancer-basal-and-squamous-cell-detection. Updated January 20, 2012. Accessed June 5, 2012.

    Cervical cancer: prevention and early detection. American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/content/CRI%5F2%5F6x%5Fcervical%5Fcancer%5Fprevention%5Fand%5Fearly%5Fdetection%5F8.asp?sitearea=PED. Updated October 2009. Accessed January 20, 2010.

    Cervical cancer screening. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated April 9, 2012. Accessed June 5, 2012.

    Colorectal cancer screening. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated May 24, 2012. Accessed June 5, 2012.

    CT colonography. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated November 2009. Accessed March 30, 2010.

    Estimated new cancer cases and deaths by sex, US, 2008. American Cancer Society website. Available at: http://www.cancer.org/downloads/stt/CFF2008Table%5Fpg4.pdf . Published 2008. Accessed August 4, 2008.

    Friedman J. Cancer screening in premenopausal women. Family Practice Recertification. 2002;24:53-61.

    Guidelines for cancer screening in patients at average risk. Am Fam Physician. 2000;62:1649-1650.

    How many women get breast cancer cancer? American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/content/CRI%5F2%5F2%5F1X%5FHow%5Fmany%5Fpeople%5Fget%5Fbreast%5Fcancer%5F5.asp?sitearea= . Accessed August 4, 2008.

    How many women get cervical cancer? American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/content/CRI%5F2%5F2%5F1X%5FHow%5Fmany%5Fpeople%5Fget%5Fbreast%5Fcancer%5F5.asp?sitearea= . Accessed August 4, 2008.

    How many women get ovarian cancer? American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/content/CRI%5F2%5F2%5F1X%5FHow%5Fmany%5Fwomen%5Fget%5Fovarian%5Fcancer%5F33.asp?sitearea= . Updated February 2008. Accessed August 4, 2008.

    Mammography. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated January 2010. Accessed March 29, 2010.

    Melanoma. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated September 2009. Accessed March 29, 2010.

    Prevention Checklist for Women. American Cancer Society website. Available at http://www.cancer.org/acs/groups/content/@nho/documents/webcontent/cancerpreventionandearlydetect.pdf. Updated April 14, 2011. Accessed March 15, 2011

    Screening for melanoma. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated December 2009. Accessed March 29, 2010.

    Stool DNA test. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/dna-stool-test/MY00623. Updated June 2009. Accessed March 30, 2010.

    Uterine cancer. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated January 2010. Accessed March 29, 2010.

    Vick T. Routine screening for cervical, breast and colorectal cancers. The Female Patient. 2002;27(suppl):20–24.

    What are the key statistics about cervical cancer? American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/content/CRI%5F2%5F4%5F1X%5FWhat%5Fare%5Fthe%5Fkey%5Fstatistics%5Ffor%5Fcervical%5Fcancer%5F8.asp?rnav=cri . Updated September 2009. Accessed March 29, 2010.

    What are the key statistics about ovarian cancer? American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/content/CRI%5F2%5F4%5F1X%5FWhat%5Fare%5Fthe%5Fkey%5Fstatistics%5Ffor%5Fovarian%5Fcancer%5F33.asp?sitearea= . Updated August 2009. Accessed March 29, 2010.

    What is endometrial cancer? American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/content/CRI%5F2%5F4%5F1x%5FWhat%5Fis%5FEndometrial%5FCancer.asp?sitearea= . Updated October 2009. Accessed March 29, 2010.

    What are the key statistics about endometrial cancer? American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/content/CRI%5F2%5F4%5F1X%5FWhat%5Fare%5Fthe%5Fkey%5Fstatistics%5Ffor%5Fendometrial%5Fcancer.asp?sitearea= . Updated October 2009. Accessed March 29, 2010.

    What are the key statistics for colorectal cancer? American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/content/CRI%5F2%5F4%5F1X%5FWhat%5Fare%5Fthe%5Fkey%5Fstatistics%5Ffor%5Fcolon%5Fand%5Frectum%5Fcancer.asp?sitearea=. Updated February 2010. Accessed March 29, 2010.

    What is colorectal cancer? American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/content/CRI%5F2%5F4%5F1x%5FWhat%5FIs%5FColon%5Fand%5FRectum%5FCancer.asp?rnav=cri. Updated February 2010. Accessed March 29, 2010.

    Who gets cancer? American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/content/CRI%5F2%5F4%5F1x%5FWho%5Fgets%5Fcancer.asp?sitearea=. Updated February 2009. Accessed March 29, 2010.

    3/19/2012 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Saslow D, Soloman D, Lawson H, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA: A Cancer Journal for Clinicians. 2012 Mar 14 early online.

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