Molly Grassman, PA-C, Arizona Oncology
While there is still much to learn about cancer, early detection has improved outcomes for life expectancy. When diagnosing cancer in the early stages, it can be easier to treat, and potentially even cure. Screening tests are procedures, imaging, or blood tests used to check for diseases and health conditions before there are any signs or symptoms (asymptomatic). Here are the current National Comprehensive Cancer Network (NCCN) guidelines for routine cancer screenings based on their proven ability to detect cancer earlier. Many variables affect these recommendations, and outcomes can differ depending on personal/family history of cancer, age, gender, race, and ethnicity. Please discuss with your health care professional (HCP) the appropriate screenings for you.
1. Breast: Most asymptomatic women should schedule annual mammograms and clinical breast exams starting at age 40 years. Considerations for additional breast screenings are based on findings and other risk factors. To determine if you are at average risk or increased risk, consult your HCP.
2. Lung: For those at high risk of developing lung cancer, it is recommended to be screened with a low-dose CT scan of the chest on an annual basis. High-risk classification includes patients who are older than 50 years of age with a greater than 20-pack per year history of smoking. You may not fit in this classification but still have other risk factors, such as occupational exposure or personal history of other chronic lung diseases, which may warrant further discussion with your HCP.
3. Colorectal: Starting at age 45 years, colorectal screening is indicated for most patients. There are several methods used for this screening, the most common being colonoscopy. This procedure looks directly at the inside of your colon using a flexible scope while you are under mild anesthesia. Another option is a stool sample fecal immunochemical test (FIT) which can detect occult (hidden) blood in the stool. This can be a sign of precancerous polyps or colorectal cancer. Stool DNA testing is available, screening for DNA changes that may develop into cancer as well as screening for blood shed into the stool (Cologuard and similar tests). Findings, or lack of findings, of these initial tests will determine the recommended schedule of additional follow-up testing. Be sure to coordinate timely follow-ups with your HCP or a gastrointestinal specialist.
4. Prostate: This screening is currently variable. It is recommended to discuss prostate-specific antigen (PSA) and digital rectal exam (DRE) monitoring with your HCP. Based on family and personal history, you can work together to determine if these tests could be beneficial for early detection. Generally, males will want to start screening between 45 and 75 years of age.
Cancer-related research is ongoing, which leads to continued progress in cancer detection and treatment. As such, screening recommendations may change over time. Work in partnership with your health care team to review your personal risk factors and create your individualized screening schedule. Early cancer detection is key, so don’t delay your screenings.
Molly Grassman, PA-C, has practiced as a physician assistant in Arizona since 2013. Molly is active in health care education and has written several articles for local publications on cancer-related topics, health, and wellness.