Cancer Screening

Hello Pulse MD family. Without a doubt, one of the scariest words for any patient to hear is the word “cancer.” While there are many different types of cancer, no matter what type of cancer a patient is diagnosed with, the mere mention of the “C word” in a diagnosis can be tremendously unsettling.

Several common cancers, when detected early and before symptoms present, are in fact treatable. As such, it’s important that you be your own patient advocate, and the information below can help you in this regard.

CANCER SCREENING

Breast CA

Breast cancer is the most common form of cancer found in women. Screening for breast cancer is done using mammography. Screening for average risk individuals can start at age 40, although screening can be done earlier if certain risk factors, such as a family history, are present. Screening is recommended every 1-2 years. While screening can be stopped at the age 75, we continue to offer mammography if life expectancy is at least 10 years.

Cervical CA

Screening for cervical cancer is done through Pap smear. We recommend screening start at age 21 and continue through age 65. Typically, Pap smear can be done every 3 years, but if HPV (Human Papilloma Virus) testing is added, Pap smear can be done every 5 years. For average risk individuals, screening for cervical cancer can be discontinued at the age 65 if adequate Pap smears were done within the past 10 years. Individuals who have had total hysterectomy would not need Pap smears unless the reason for hysterectomy was cervical cancer or high grade cervical cancer precursors.

Ovarian CA.

Screening for ovarian cancer is NOT recommended for individuals at average risk. However, if there’s a family history of ovarian cancer, a referral to a genetic counselor may be considered.

Colorectal CA screening

Screening for colorectal cancer is done using colonoscopy or stool test. Screening for average risk patients starts at age 45, although earlier screening is warranted if there is a family history of colorectal cancer. For most individuals, screening stops at age of 75, although we continue screening if life expectancy is estimated to be more than 10 years.

Lung CA

Screening for lung cancer is performed through low dose CT Scan of the chest. Screening is recommended annually for patients between the age of 50 and 80 who are at risk because they currently smoke, or because they have a history of smoking the equivalent of 1 pack a day for 20 years and quit within the past 15 years. Screening is stopped if an individual has not smoked for at least 15 years or if life expectancy is limited.

Prostate CA

Prostate cancer is the most frequently diagnosed cancer for men. However, the decision to undergo prostate cancer screening, done through a blood test to measure PSA (Prostate-Specific Antigen), is not a simple one. The patient has to decide for himself whether the benefits of the screening outweigh the potential harms. For example, PSA can be abnormal even if there is no prostate cancer, and maybe normal even if there is prostate cancer. If screening is performed, it typically starts at age 50 and may continue through age 69. Screening discussions can be started at age 40 to 45 for African American patients or if they have first degree relatives diagnosed with prostate cancer at age 65 or younger. Digital rectal exam is not recommended either as an adjunct to PSA or standalone test due to low sensitivity and specificity for detecting prostate CA.

Furthermore, some areas for the prostate where cancer occurs are not reachable by a finger examination.

Screening for bladder, testicular, thyroid, pancreas, oral CA has not been shown to reduce deaths.

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