The war on cancer in the United States reached a tremendous progress point in 2003- that year was the first since early in the 1930s that cancer deaths had actually fallen in absolute number.  Some of this is, of course, due to the advanced and effective treatments that have been developed by modern research.  Perhaps equally as effective are the advances made as well the heightened awareness recognized of the importance of cancer screening.  Catching cancer while it is curable or in its very early stages is making a huge difference in increasing the survival and cure rate for many forms of what was once an incurable disease.

Problemsome for the average person is that the number of cancer screening guidelines can be overwhelming, and confusion can lead to non-testing rather than a guideline that is patient friendly and easier to follow.  As colon, breast, cervix and prostate are the four major areas where screening can make a huge difference, let’s examine the latest screening guidelines and recommendations for them:

Colon cancer:  The American Cancer Society, which is at the forefront of cancer prevention, outlines five screening alternatives for people when they reach the age of 50.  They include a full colonoscopy every ten years, annual stool screening for blood plus a flexible sigmoidoscopy every five years, flexible sigmoidoscopy itself every five years, annual stool for occult blood, or double contrast barium enema every five years.  Each strategy has strong preventative benefits if used consistently.

Which one then, should a doctor choose?  A lot of factors, including access to care, insurance coverage, and patient discomfort enter into choices.  All being equal, the colonoscopy appears most helpful as it has the most direct view of possible lesions and the ability to biopsy or remove them at the same time.  However, all of the alternatives are satisfactory if colon cancer risks are equal.  Those, however, who have a strong family history of cancer, and particularly colon cancer, should have their doctor follow them regularly and may need even more frequent screening.

Breast Cancer:  The American Cancer Society recommends clinical examination on a regular basis by a doctor from age 20-39, and regular mammography beginning at age 40.  There are differences in these guidelines from previously: mammography used to be entertained only every two to three years in women after age 40 and many women were traditionally not screened until they were above the age of 50. It is also recommended that high-risk women, who have strong breast cancer histories in their family, have a genetic history of breast cancer, or whose breast are cystic and difficult to examine should consult with their doctor to determine the best screening modality for them.  Breast self examination by women is highly recommended on a continual and regular basis, with any abnormality being brought quickly to the doctor’s attention.

Cervical Cancer: The American Cancer Society recommends that cervical cancer screening begin approximately three years after the onset of vaginal intercourse, but no later than age 21.  The screening is recommended yearly until age 30, and then every two to three years after three consecutive normal tests have been documented.  High risk behavior or multiple sexual partners should probably continue yearly screening, and those over age 70 or those who have had a hysterectomy no longer require routine screening,

Prostate Cancer:   The American Cancer Society (ACS) recommends digital rectal examination by the doctor yearly beginning at age 50.  Additionally, a PSA test (prostate specific antigen blood test) should also be performed annually.  Of all the cancer screening, prostate cancer is the most controversial.  Many prostate cancers can remain inconsequential for many years, and there are no firm endorsements by any major US medical organization for screening of average risk men.  However, the ACS, American College of Physicians and American Academy of Family Physicians all advise direct patient education of the benefits of prostate screening beginning at age 50 and even earlier in high risk males, which include both African American men and men who have a first degree relative with prostate cancer.

Insurance plans now cover many cancer screening procedures.  Discuss them with your doctor, and take advantage of the ones that most benefit you on a regular basis.