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Cancer Screening Test Guidelines

Here are the screening test guidelines for different types of cancer according to
American Cancer Society and U.S. Preventive Task Force Services:

1. Breast Cancer

Seventy percent of women have no known predisposing factors to breast cancer but
certain risk factors have been established. Risk factors include age 65 and above,
two first-degree relatives diagnosed with breast cancer at an early age, high breast
tissue density, and factors that affect circulating hormones like late menopause,
long-term use of hormonal replacement therapy, and obesity.

Breast cancer screening includes mammography, clinical breast examination (CBE),

and breast self-examination (BSE). It is important that patients understand what
these examinations are all about, how they are performed, and their limitations.

Mammogram. Image via: Wikipedia.

Mammogram. Image via: Wikipedia.
Mammography (x-ray of the breast) is done yearly for women age 40 and above.
However, for women with increased risk, it may be started at age 30. CBE is done
every 2-3 years among women 20-39 years of age and then annually after 40 years
of age. Basically, this is a physical exam done by a healthcare provider as part of
the regular medical check-up. Lastly, nurses should teach women 20 years of age
and above on how to perform BSE. This should be done 5-7 days after menstruation
when the breasts are not swollen and tender. For women with an irregular sexual
cycle, a specific date must be chosen for monthly BSE.

2. Cervical Cancer

Pap Smear

The screening test for cervical cancer is Pap Smear. In 2012, the American College
of Obstetricians and Gynecologists (ACOG) released a new guideline for this test.
First screening should be at age 21. For women age 21 to 39, screening is done
every three years. Until age 60, screening is done with cytology if Pap Smear is
positive or if the patient is at high-risk for HPV test. For women who have undergone
hysterectomy for benign reasons, routine screening is discontinued. Lastly, for
women age 65 and above, routine screening is discontinued if three consecutive
Pap smear result is negative.

3. Ovarian Cancer

Currently, there is no effective screening test for ovarian cancer although risk
factors would include history of breast or ovarian cancer in the family and mutation
in BRCA1 and BRCA2 genes.

Pelvic exam
Pelvic exam
Pelvic exam is done upon check-up and the doctor would request ultrasound and
magnetic resonance imaging (MRI) as needed.

4. Testicular Cancer

Testicular self exam.

Testicular self exam.
Monthly testicular self-examination (TSE) is recommended for men. A painless
nodule or lump felt is always advised to be reported to the doctor. TSE should be
done after a warm shower so the skin is relaxed.

5. Lung Cancer

Low-dose computer tomography annual screening for lung cancer is recommended

for adults age 55-80 years with smoking history of 30 pack years or have quit
smoking within 15 years. Screening is discontinued if the person has stopped
smoking for at least 15 years.

6. Liver Cancer

American Cancer Society has no current recommendations for liver cancer

screening. However, two most commonly requested test for liver cancer includes
ultrasound and alpha-fetoprotein (AFP) blood test.

7. Colorectal Cancer

Screening recommendations for colorectal cancer include fecal occult blood test
(FOBT), sigmoidoscopy, and colonoscopy.

Assessment for risk factors (e.g. polyps, first-degree relative with colorectal cancer,
personal history of ulcerative colitis, etc.) should begin at age 20. However, for
those who are not high risk, routine screening recommendations should take place
between 50 and 75 years of age.

FOBT is conducted annually. Another option is to have sigmoidoscopy every five

years and FOBT every three years. Third option on the list is to have colonoscopy
every 10 years.

8. Prostate Cancer

digital rectal exam

Prostate cancer is the leading cancer among men in the U.S. and the second leading
cause of death. Risk factors include age, history of prostate cancer in the family and
African American ethnicity. Screening recommendations include digital rectal
examination (DRE) and prostate-specific antigen (PSA). However, these two
methods are not highly accurate. DRE can miss as much as 25-35% of tumors and
its sensitivity is only 59%. PSAs detection rate is only 28-35%. It is being
recommended to combine the two screening options for men above 50 years of
age. For men with risk factors, screening should be started at age 40.

9. Skin Cancer

As of now, theres not enough evidence to recommend a routine screening that can
detect skin cancers early. However, it is important to note that fair-skinned
individuals aged 65 and older are at increased risk for melanoma. Having atypical
moles and/or more than 50 moles increase the risk of the person for melanoma too.