Cancer Screening Guidelines

Cervical Cancer

Two types of test are used to test for cervical cancer. Both use cells which have been removed from the cervix during a pelvic exam.

1. PAP test: detects changes within the cells which indicate cancer.  Capable of detecting very early changes, the PAP is very sensitive.
2. HPV (human papilloma virus) test: detects the sexually transmitted virus that causes changes in the cells of the cervix which lead to cancer.  The majority of cervical cancers are related to infection with HPV.

Who should have it and how often?
Women should begin testing at age 21.
Between the ages of 21 and 29, PAP test should be done every 3 years. They should not be tested for HPV unless it is needed after an abnormal PAP test result.
Between the ages of 30 and 65, a PAP and HPV should be done every 5 years. OR a PAP alone every 3 years.
Over the age of 65, women who have had regular screenings with normal results do not need to be screened for cervical cancer. Women who have had pre-cancer results in the past should be continued to be screened.
Women who had hysterectomies with the cervix removed and have no history of cervical cancer or pre-cancer do not need to be screened.
Women who have been vaccinated for HPV should follow the guidelines above for their age group.
Women who are at high risk for cervical cancer should be screened more frequently. (HIV positive, organ transplant, or exposure to the drug DES.) They should talk with their doctor or nurse.

Where you can have it done:**
Any health care provider who performs pelvic exams should be able to provide the PAP and HIV testing.

*Guidelines from: http://www.cancer.org/cancer/news/new-screening-guidelines-for-cervical-cancer

Colorectal Cancer

High-Sensitivity Fecal Occult Blood Test (FOBT) or Fecal Immunochemical Test (FIT)

Ask your doctor for a high-sensitivity FOBT or FIT.
The one time FOBT done by the doctor in the doctor’s office is not appropriate.

Note: There are two types of FOBT: one uses the chemical guaiac to detect blood.  The other, a fecal immunochemical test (FIT), uses antibodies to detect blood in the stool.  You can receive a test kit from your health care provider.

How often you should have it:
Beginning at age 50 once a year.  (If anything unusual is found, your doctor will recommend a follow-up colonoscopy.)

Where you can have it done:
Any primary care provider will provide the test kit for you to collect stool sample at home and send the test in to the laboratory for testing.

OR

Sigmoidoscopy: 

How often you should have it:
Beginning at age 50/ Once every 5 years; with the FOBT or FIT at 3 years.  (If anything unusual is found, your doctor will recommend a follow-up colonoscopy.)

Where you can have it done:

OR

Colonoscopy: 

An examination of the entire colon with a lighted microscopic tube allows the physician to see any abnormality of the inside of the colon.  Prep is required to cleanse the colon of fecal matter prior to testing and sedation is required.

You can schedule your own! Just have a primary care provider to which the results may be sent.

How often you should have it:
Ages 50-75: once every 10 years

Considered the GOLD STANDARD for Colorectal cancer screening. Removal of suspicious tissue can be removed at the time of exam. 

Where you can have it done:

Call 844.GO.SOVAH to schedule a consultation with a local gastroenterologist or general surgeon.

*If you have a family history of colorectal cancer or polyps, you should have the tests beginning at age 40 or 10 years earlier than the age of the youngest family member at time of their diagnosis.

Lung Cancer

Lose Dose CT scan (LDCT):

Detects lung cancer much earlier and usually pre-symptomatic than the previously recommended annual chest x-ray.  Lung cancer symptoms usually do not occur until the disease is at advanced stage and incurable.  Limitations of LDCT is that it is very sensitive - it picks up abnormalities that may not be cancer, but which must be investigated to rule out early cancer.  LDCT does require specialized equipment and should only be done at facilities that are capable of providing the appropriate follow-up care and testing.

Who should have it and how often?
Every year. Those who are at the highest risk of developing lung cancer:

• • Age 50-77 for Medicare Insured patients.
  • Age 50-80 for Commercial and Medicaid Insured patients.
  • Tobacco history of at least 20 or more Pack-Years (Pack-Year = smoking one pack per day for one year).
  • Current smoker or one who has quit smoking the the last 15 years. 

Where you can have it done:**

There are no other recommended screening tests for lung cancer. Traditional chest x-rays are not acceptable for screening.

*Guidelines according to the American Cancer Society, Lung Cancer Screening Guidelines

Prostate Cancer

Prostate-specific antigen (PSA):

A simple blood test used to detect a protein produced by the prostate gland.  The prostate gland is normally a walnut sized structure located around the base of the urethra in men.  The prostate produces PSA at low levels in normal conditions and at increased levels in several conditions including inflammation of the prostate (prostatitis) and malignancy. For this reason, it is recommended that a single increased PSA level not be used as an indicator for cancer.

Digital Rectal Exam (DRE)

Recommended as part of annual physical exams for men.  The prostate gland may be palpated by the physician by inserting a finger into the rectum.  Enlargement of the prostate is normal during advanced aging and may cause urinary and sexual function issues in men middle age and older.

Who should have it and how often?
At age 50: men should begin discussion with health care provider about the pros and cons of testing with these indicators in mind:

This discussion should begin at age 45 if:

• African American (AA males develop prostate cancer about 2x the rate of men of other races.)

or

• A father or brother who has been diagnosed before the age of 65.

Each individual man should discuss with his health care provider whether to be tested for prostate cancer. An elevated PSA or enlarged prostate may cause needless and excessive stress and worry for the patient. Further testing involving biopsy and other invasive procedures may not be warranted for a single or even multiple elevated PSA. Prostate cancer is thought to be slow growing, so men with an expected life left of 10 years or less should not be subjected to further testing.

It is suggested that men with slightly elevated levels take a “watchful waiting” approach with a committed re-test at 6 month intervals or as recommended by the provider.

Where you can have it done:**
Any health care provider can draw blood for a PSA and most can perform the digital rectal exam.

Call 844.GO.SOVAH to schedule a consultation with a local urologist.

*Guidelines from:http://www.cancer.org/cancer/prostatecancer/moreinformation/prostatecancerearlydetection/prostate-cancer-early-detection-acs-recommendations

** http://www.cancer.gov/cancertopics/factsheet/Detection/PSA

Skin Cancer

According to the American Cancer Society, most skin cancers can be found early with skin exams. Exams by your doctor and checking your own skin frequently can help find cancers early when they are easier to treat. Regular skin exams are especially important for people who are at higher risk of skin cancer, such as people with reduced immunity, people who have had skin cancer before, and people with a strong family history of skin cancer. Talk to your doctor about how often you should have your skin examined.

https://www.cancer.org/cancer/skin-cancer/galleries.html