A cancer screening is a test performed to look for abnormalities, such as cancer. For each type of cancer, research has shown at what age patients are most likely to get cancer. This is why age is the primary criteria for each type of screening. Age is not the only factor, however. Family history, race and exposure to certain chemicals also affect the likelihood that a person may get cancer. Your healthcare provider is the best person to help you decide when to get a cancer screening and what type of screening to have. There are, however, guidelines that determine when and how the average person should be screened, unless otherwise directed by their healthcare provider.
The role of family history and race
Family history can greatly influence someone’s risk of having cancer.The age guidelines listed above only apply to those of average risk.In order to determine at what age you will need to begin cancer screenings, you should have a conversation with your primary care provider many years before the average screening age. With breast cancer and colon cancer screenings this conversation should take place 10 years before you reach the age when your sibling or parent had cancer. Prostate cancer screenings may need to start as early as age 40, depending on family history.
Race is also a factor in cancer screenings. Colon cancer is more prevalent among African American men and those of Ashkenazi Jewish heritage. African American men are also more susceptible to prostate cancer. If you are a member of a vulnerable population, it is important to discuss screening ages with your primary care provider ten years before the average screening age.
Cancer Screening Guidelines
Colon Cancer Screenings
There are several methods of colon cancer screenings. In order to be screened for colon cancer you will need a referral appointment with your provider. At this appointment you and your provider can discuss which screening test is best for you. Adults age 50 to 77 need to be screened for colon cancer. Adults age 76 to 85 should be evaluated by their healthcare provider to determine their screening needs. Colon cancer screenings can detect polyps, or growths inside the colon, that may eventually turn into cancer. These polyps can be removed as soon as they are detected, before they become cancerous. In this way colon cancer can be prevented.
Prostate Cancer Screenings
Prostate cancer screenings should begin at age 50. There are multiple screening methods. Some may be done by your primary care provider and some require a referral to another testing facility. You should make an appointment with your healthcare provider to discuss which type of screening is best for you.
Lung Cancer Screenings
Not all patients need lung cancer screenings. Most lung cancer screenings involve a CT lung scan, which takes pictures of the lungs. CT lung scans are usually done on patients between age 55 and 74 who have smoked a 30 pack-year (see below).
The 30 pack-year rule and the age guidelines are not absolute, however. It is important to discuss your smoking history with your primary care provider. For this reason, a lung cancer screening requires a preliminary referral appointment before the CT lung scan can be done.
Examples of a 30 Pack-year
Smoking a pack a day for 30 years
Smoking 2 packs a day for 15 years
Smoking 3 packs a day for 10 years
Breast Cancer Screenings
Mammograms are x-rays of the breast. They are the best way to detect the presence of breast cancer early, when treatment may be more successful, especially when combined with a yearly clinical breast exam (CBE) by their health care provider. There are many different opinions on when screening mammograms should start and end for average risk women. American Cancer Society (ACS), US Preventative Task Force (USPTF) and American College of Radiology (ACR) all have slightly different recommendations. The American Congress of Obstetrics and Gynecology (ACOG) recommends that starting at age 40, women should get a mammogram every year until age 75 (or older if patient wants to continue screening). A Mammogram at RMH must be ordered by a provider, and then may be scheduled directly with the imaging department. For many patients who cannot afford a mammogram, grant funds are available. Contact RMH Social Services office if you feel you may be eligible for free screening.
Cervical Cancer Screenings
Cervical cancer screening recommendations are evolving, and have changed significantly over the past 2 decades. Screening for cervical cancer is primarily by a test called a Pap smear (which is not synonymous with a pelvic exam). It is a good idea for women to have an annual visit with a gynecologist or other health care provider: a Well Woman Visit (WWV). A WWV is covered annually by insurance, except Medicare. The focus of this visit is the maintenance of female health, and screening for medical problems that affect women. A pelvic exam and or Pap may be done at a typical yearly WWV. The frequency of these interventions are based on a patient’s own risks as well as her desires after a discussion with her provider. No woman needs a routine pelvic exam or Pap before age 21, especially if the only reason for the visit is to start birth control. Certainly, a pelvic exam is indicated if there are certain complaints or symptoms bothering the woman. Regular Cervical Cancer screening should continue from age 21 to at least until age 65, but is not recommended yearly now for average risk women. The most effective screening method is a pap smear in combination with Human Papilloma Virus (HPV) testing. Cervical cancer screening with a Pap smear and HPV testing is generally recommended every 3 to 5 years during a yearly well woman visit (WWV) after age 21, and the test frequency depends on the patient’s age and risk factors. A well woman visit is scheduled directly by the patient with her gynecologist or her primary care provider.