Cancer Prevention : What screening tests should women undergo?

There are two major components of early detection of cancer. Education to promote early diagnosis and screening.

Recognizing possible warning signs of cancer and prompt action leads to early diagnosis. Some early signs of cancer include lumps, sores that fail to heal, abnormal bleeding, persistent indigestion, and chronic hoarseness. Early diagnosis is particularly relevant for cancers of the breast, cervix, oral cavity, colon and rectum, and skin. Screening refers to the use of simple tests across a healthy population in order to identify individuals who have disease, but do not yet have symptoms.

The screening tests

Breast Cancer

• Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health.
• Clinical breast exam (CBE) should be part of a periodic health exam, about every 3 years for women in their 20s and 30s and every year for women 40 and over.
• Women should know how their breasts normally feel and report any breast change promptly to their health care providers. Breast self-exam (BSE) is an option for women starting in their 20s.
• Women at high risk (greater than 20% lifetime risk) should get an MRI and a mammogram every year. Women at moderately increased risk (15% to 20% lifetime risk) should talk with their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram. Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is less than 15%.

Cervical Cancer

• All women should begin cervical cancer screening about 3 years after they begin having vaginal intercourse but no later than when they are 21 years old. Screening should be done every year with the regular Pap test or every 2 years using the newer liquid � based Pap test.
• Beginning at age 30, women who have had 3 normal Pap test results in a row may get screened every 2 to 3 years. Another reasonable option for women over 30 is to get screened every 3 years ( but not more frequently) with either the conventional or liquid based Pap test, plus the HPV DNA test. Women who have certain risk factors such as diethylstilbestrol (DES) exposure before birth, HIV infection, or a weakened immune system due to organ transplant, chemotherapy, or chronic steroid use should continue to be screened annually.
• Women 70 years of age or older who have had 3 or more Pap test in a row and no abnormal Pap tests in the last 10 years may choose to stop having cervical cancer screening. Women with a history of cervical cancer, DES exposure before birth, HIV infection or a weakened immune system should continue to have screening as long as they are in good health.
• Women who have had total hysterectomy (removal of the uterus and cervix) may also choose to stop having cervical cancer screening, unless the surgery was done as a treatment for cervical cancer or pre-cancer. Women who have had hysterectomy without removal of the cervix should continue to follow the above guidelines.

(The doctor is MS (Gen), DNB (Surg), Mch (Surg, Onco), FRCS (Edin) Diploma in lap Surg (France) Chief Surgical Oncologist Vamsy1964@gmail.com 9848011421)