Cancer Screening

Early Detection for Better Health Outcomes

Cervical Cancer

The American Cancer Society recommends these screening guidelines to help find cervical cancer early. Following these guidelines can also find precancers, which can be treated to keep cervical cancer from starting.

  • Cervical cancer testing (screening) should begin at age 25.
  • Those aged 25 to 65 should have a primary HPV test* every 5 years. If primary HPV testing is not available, screening may be done with either a co-test that combines an HPV test with a Papanicolaou (Pap) test every 5 years or a Pap test alone every 3 years.
  • Those over the age of 65 who have had regular screening in the past 10 years with normal results and no history of CIN2 or more serious diagnosis within the past 25 years should stop cervical cancer screening. Once stopped, it should not be started again.
  • People who have had a total hysterectomy (removal of the uterus and cervix) should stop screening (such as Pap tests and HPV tests), unless the hysterectomy was done as a treatment for cervical cancer or serious precancer. People who have had a hysterectomy without removal of the cervix (called a supra-cervical hysterectomy) should continue cervical cancer screening according to the guidelines above.
  • People who have been vaccinated against HPV should still follow these guidelines for their age groups.
  • Some people believe that they can stop cervical cancer screening once they have stopped having children. This is not true. 
  • If you have a history of precancerous cells, you should continue to have testing for at least 25 years after that condition was found, even if the testing goes past age 65.
  • Those who are at high risk of cervical cancer because of a suppressed immune system (for example, from HIV infection, organ transplant, or long-term steroid use) or because they were exposed to DES in utero may need to be screened more often. They should follow the recommendations of their health care team.

Prostate Cancer

  • The American Cancer Society recommends that men make an informed decision with a health care provider about whether to be tested for prostate cancer.
  • Starting at age 50, men should talk to a health care provider about the pros and cons of testing so they can decide if testing is the right choice for them.
  • If you are African American or have a father or brother who had prostate cancer before age 65, you should have this talk with a health care provider starting at age 45.
  • If you decide to be tested, you should get a PSA blood test with or without a rectal exam. How often you’re tested will depend on your PSA level.
  • Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years
  • Age 45 for men at high risk of developing prostate cancer. This includes African American men and men who have a first-degree relative (father or brother) diagnosed with prostate cancer at an early age (younger than age 65).
  • Age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age). 

Colorectal Cancer

Despite the risks, 1 in 3 adults ages 50 – 75 are still not being screened as recommended. The American Cancer Society recommends that people at average risk of colorectal cancer should start regular screening at age 45. 

Screening can be done with either a sensitive (stool-based test) or a colonoscopy (visual exam of the colon & rectum). 

Risk factors include but are not limited to: 

  • History of certain types of polyps 
  • Family history of colorectal cancer 
  • Personal history of irritable bowel disease like ulcerative colitis or Crohn’s disease 
  • History of getting radiation to the abdomen or pelvic area, in treatment of a prior cancer 
  • High intake of red meat 
  • Smoker 
  • Minority populations 

Signs & Symptoms

  • A change in bowel habits such as diarrhea, constipation or narrowing of the stool that lasts for more than a few days 
  • Rectal bleeding with bright red blood 
  • Cramps/ Belly Pain 
  • Blood test showing a low red blood count 
  • Weakness & fatigue 
  • Unintended weight loss  

*Many of these symptoms can be caused by conditions other than colorectal cancer, such as infection, hemorrhoids, or irritable bowel syndrome. Still, if you have any of these problems, it’s important to see your doctor.

Breast Cancer

Breast cancer is the most commonly diagnosed cancer in women in the United States and the second leading cause of cancer death in American women. With early detection, the survival rates for breast cancer are nearly 100%.

Self-screening

The first step is breast awareness. Knowing if there are changes in your own breasts by doing periodic self-exams is extremely important. 

Women at average risk
  • Starting at age 25, women with an average risk should have a clinical encounter yearly (with a PCP for example) and risk of breast cancer should be assessed.
  • Clinical breast exam should occur every 1 – 3 years.
  • Ages 40 – 74:  Mammography every 2 years 
  • Consider annual screening if desired between ages 40-44.
Risk Factors
  • Family history / genetic factors: there are genes clearly associated with increased risk of breast cancer such as the well-known BRCA 
  • A Less common risk factor but one with a clear association with breast cancer is thoracic radiation (radiation to the chest) as a child or young adult which can be an important and very necessary treatment for childhood lymphomas. 
  • Increased BMI (body mass index) being overweight or obese is a risk factor
  • Hormone replacement therapy (estrogen/progesterone treatment for menopausal symptoms over a prolonged period of time)
  • Alcohol consumption:  More than 1 glass of wine per day for women has been shown to increase risk
  • And smoking.
Women at increased risk
  • Screening should be individualized based on risk factors
  • May include earlier screening, more frequent screening, or additional tests (e.g., MRI)
  • Breast imaging may then be started at an age younger than 40.
  • Yearly breast MRI which increases sensitivity in finding cancer may also be added.
  • Sometimes medication (Tamoxifen for example) is recommended in high-risk non-cancer patients to decrease the chance of developing breast cancer.

At Highlands we have a dedicated clinic for monitoring higher risk patients.

“The Cancer Assessment and Risk Education or C.A.R.E. clinic”

Patients who have been identified as having an increased risk of developing breast cancer are referred to our CARE clinic for more intensive monitoring, which may include genetic testing, MRI and other testing to reduce the risk of having breast cancer.  Learn more about the CARE clinic

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LUNG CANCER

  • Lung cancer is one of the most common types of cancer in both men and women, and it is by far the leading cause of cancer deaths.
  • People who smoke or used to smoke are at higher risk for lung cancer, and this risk goes up based on how much and how long someone has smoked. Although quitting smoking lowers the risk of lung cancer over time compared to continuing smoking, the risk is still higher than among people who have never smoked.
  • By the time lung cancer starts to cause symptoms, it has often grown too big (or spread too far) for it to be removed completely.
  • Very early lung cancers usually do not cause any symptoms. Screening can help find these cancers early, when treatment is most likely to be successful.
  • Many deaths from lung cancer could be prevented if people who qualify for lung cancer screening were tested every year.
  • Although most lung cancers are caused by smoking, lung cancer can also occur in people who have never smoked. However, at this time, it’s very hard to tell which people who have never smoked might be at high enough risk for lung cancer to include them in the screening recommendations.
Criteria for Screening
  • If you are 50 years or older with a long history of smoking
  • If you have a history of cancer
  • If you have been exposed to occupational or environmental cancer-causing substances (ex:  Mesothelioma)
  • If you have a family history of lung cancer

Highlands established a community wide FREE lung cancer screening program in 2013, to address the dismal outcomes patients were faced with as they were being diagnosed with lung cancer at stage III or IV.   Early detection saves lives and that means finding cancer before you have symptoms.  Learn more about the Free Lung Cancer Screening Program

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