Cancer Screening: Give Yourself an Edge

Breast cancer is the most common cancer among American women after skin cancer. This year, more than 225,000 women in the United States will learn they have breast cancer. Three-fourths of them will be 50 or older, but breast cancer also affects younger women and a handful of men.

Currently the best tool for breast-cancer screening is a mammogram—an X-ray of the breast—coupled with a clinical exam by a health care practitioner. Cancers found on mammograms are usually smaller than cancers that can be felt, and they are less likely to have spread. For some women, early detection may prevent the need to remove the entire breast or receive chemotherapy. And, most importantly, regularly scheduled mammograms can decrease a woman’s chance of dying from breast cancer.

The National Cancer Institute recommends women in their 40s and older have mammograms every one to two years. Women at a higher-than-average risk for breast cancer due to one of the following risk factors may need more frequent mammograms or medical evaluations:

• If you’ve had breast cancer before.
• If you carry a specific genetic change that increases susceptibility to breast cancer.
• If your mother, sister, daughter or two or more close relatives, such as cousins, have had breast cancer.
• If you have a breast condition that may predispose you to breast cancer.
• If you have high breast density.

This year, nearly 140,000 Americans will be diagnosed with colon or rectal cancer, and nearly 51,000 will die from it. Many of these deaths are preventable.

Colon cancer is perfect for successful screening because it is very slow growing. It usually begins with small growths called polyps, which can take 10 or more years to develop into cancer. Removing polyps in their early, precancerous state ensures they won’t be around to cause cancer later. Screening also can identify cancer early, when it can be completely cured.

Screening may reduce the risk of ever being diagnosed with colon cancer by as much as 70 percent. And if all colon cancer cases were detected early, the overall survival rate would improve from 64 percent to 90 percent.

The American Cancer Society suggests that men and women follow one of these screening options, beginning at 50:

• Colonoscopy every 10 years.
• Yearly stool-blood test plus flexible sigmoidoscopy every five years.
• Flexible sigmoidoscopy every five years.
• Yearly stool-blood test.
• Double-contrast barium enema every five to 10 years.

Some people, such as those with family history of the disease, have a higher risk than the general population and would likely benefit from earlier and more frequent screening.

Prostate cancer is the most common cancer among men in the United States after skin cancer. An estimated 240,000 men will be newly diagnosed this year and about 28,000 will die from the disease. While one man in six will get prostate cancer during his lifetime, only one man in 35 will die from it. 

Compared to many other cancers, prostate cancer grows very slowly. It may be decades from the time the first cell changes can be detected under a microscope until the cancer is big enough to cause symptoms, if at all.

The main screening tools are:

• Digital-rectal exam (DRE), in which the doctor feels the prostate gland through the rectal wall to check for bumps or abnormal areas. Patients experience only slight discomfort during the exam.
• Prostate-specific antigen (PSA) test, which measures the level of protein in the blood that rises when the prostate gland enlarges. PSA levels alone do not give doctors enough information to distinguish between benign and cancerous conditions, but doctors take this test’s results into account in deciding whether to check for further signs of prostate cancer.

Doctors’ recommendations for prostate-cancer screening vary because it is not always clear that benefits outweigh the risks of some diagnostic tests and treatment. Some doctors encourage yearly screening for men over age 50; others recommend against screening; still others counsel men about their risks and benefits on an individual basis and encourage patients to make personal decisions about screening.

More than 96 percent of prostate-cancer cases occur in men 55 or older.  Men who have a father or brother with prostate cancer have a greater chance of developing the disease, and African-American men have the highest rate of prostate cancer. Therefore, these groups would benefit the most from screening. 

A booklet that can help you decide if prostate-cancer screening is right for you, “Understanding Prostate Changes,” is available by calling 1-800-4-CANCER.