We will talk about breast and colon cancer screening in this article after I discussed cervical and prostate cancers in Part 1.
No, I didn’t forget about lung cancer but there are no screening methods for it yet, although CT scans with low dose radiation for high risk patients (like smokers above the age of 50) may become an option soon.
An approach to breast cancer screening should incorporate an individual’s level of breast cancer risk, established by history and by use of a risk prediction calculator (can be found online). Women with mild to moderate lifetime cancer risk should be screened with a mammography starting at the age of 50.
Between ages 40 and 50, a discussion about the risks and benefits should be undertaken with the health care providers especially if one has dense breasts or a weak family history of breast cancer. Women over the age of 70 may be screened if their life expectancy is at least ten years.
The ideal interval for screening is not known, but it is suggested to be every one to two years. Clinical breast examination is recommended unlike breast self-examination which is of unproven efficacy.
Women at high lifetime cancer risk should be referred for genetic testing and should have annual mammography and MRI, as well as clinical breast examinations every three to six months and monthly breast self-examinations. Their screening should be initiated at age 25.
Screening for colon cancer has been shown to decrease mortality by identifying polyps with malignant potential and early stage cancers. It is recommended that average-risk patients start screening at the age of 50 and continue until their life expectancy is less than 10 years. You can either do colonoscopy (long camera that goes through the rectum) every ten years, CT colonography (like a CT scan) every five years, sigmoidoscopy (short camera that goes through the rectum) every five years, test stools for blood yearly or for DNA every five years. Patients with a first degree relative or two or more second degree relatives with colorectal cancer should discuss their cases with their providers as these recommendations do not apply to them.