Middle-age tests: Cancer screenings

September 07, 2000

Middle-age tests: Cancer screenings

Breast cancer

American Cancer Society estimates there will be 182,800 new cases and 40,800 deaths from breast cancer in 2000.

Mammograms have been credited with early detection of more breast cancer and reducing the number of deaths from the disease.

There is debate and some controversy about when women should begin having mammograms. American Cancer Society recommends women begin annual mammograms at 40. American Medical Association recommends the screening for women ages 40 to 49 every one to two years and once a year after age 50. U.S. Clinical Preventive Services Task Force recommends annual mammograms at age 50. Talk to your doctor about screenings earlier if your family history warrants it.

There is little disagreement, however, that all women - American Cancer Society sets the starting line at age 20 - should do monthly self-examination of their breasts and have their breasts examined every three years by a health-care provider. At age 40, the organization recommends an annual examination by a health-care provider.

Cervical cancer

American Cancer Society estimates there will be 12,800 new cases and 4,600 deaths from cervical cancer in 2000.

Pap tests, developed in the 1940s, are credited with reducing death from cervical cancer by 73 percent since 1950, according to a U.S. Clinical Preventive Services Task Force report.

Women who are sexually active or who have reached the age of 18 should have an annual Pap test and pelvic examination, advises American Cancer Society.

U.S. Clinical Preventive Services recommends beginning Pap screenings when sexual activity begins. Screening frequency - every one to three years - should be decided by the physician.

Tests may be discontinued at age 65 if previous tests have been consistently normal, according to Preventive Services guidelines.

Ovarian cancer

Ovarian cancer is not mentioned in the American Cancer Society's publication "Cancer Prevention & Early Detection, Facts & Figures 2000."

While mammograms screen for breast cancer and Pap tests screen for cervical cancer, there is no good screening test for ovarian cancer. Transvaginal ultrasound and the CA125 tumor marker, a blood test, may assist in diagnosis but are not recommended for routine screening, according to American Cancer Society.

Symptoms, which may include fatigue and fullness, are nonspecific. "I can't tell you how many times a day I hear that," said Dr. Brian Bonham of Myersville Internal Medicine and Pediatrics in Myersville, Md.

Skin cancer

American Cancer Society estimates there will be approximately 1.3 million new cases of highly curable basal cell or squamous cell cancers and 1,900 deaths from nonmelanoma skin cancer in 2000.

The organization estimates that this year there will be 47,700 cases of and 7,700 deaths from melanoma, the most serious form of skin cancer.

The best way to find skin cancer early is to recognize changes in skin growths or to notice new growths. See a physician if there is a sudden or progressive change - especially a change in size or color - in a mole's appearance.

Colorectal cancer

American Cancer Society estimates there will be 93,800 new cases and 47,700 deaths from colon cancer in 2000.

The organization estimates there will be 36,400 new cases and 8,600 deaths from rectal cancer in 2000.

There is debate about screening. American Cancer Society recommends the following for people ages 50 and older:

HEIGHT="6" ALT="* "> Fecal occult blood test and flexible sigmoidoscopy: If normal, repeat fecal occult blood test annually, sigmoidoscopy every five years if normal.


HEIGHT="6" ALT="* "> Colonoscopy: If normal, repeat every 10 years.


HEIGHT="6" ALT="* "> Double-contrast barium enema: If normal, repeat every five to 10 years.

A rectal exam should be done at the same time as sigmoidoscopy, colonoscopy or double-contrast barium enema.

Discuss a screening schedule with your physician if you have risk factors, including personal or family history of polyps, chronic inflammatory bowel disease or colorectal cancer.

Prostate cancer

American Cancer Society estimates there will be 180,400 new cases and 31,900 deaths from prostate cancer in 2000.

With the exception of skin cancer, prostate cancer is the most common cancer in men. Its incidence increases with age.

Because treatment can have undesirable side effects, screening is not universally recommended.

American Cancer Society recommends that men 50 and older who are expected to live at least 10 more years discuss screening with their health-care provider.

Screening includes annual rectal examination of the prostate - the walnut-sized male sex gland - and a PSA (prostate specific antigen) blood test.

Men who are at higher risk - African-Americans and those who have a family history of prostate cancer - should consider screening at an earlier age.

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