CANCER SCREENING TESTS

Checking for cancer (or for abnormal cells that may become cancer) in people who have
no symptoms is called screening.

Screening tests can help nd cancer at an early stage, before symptoms appear.
When abnormal tissue or cancer is found early, it may be easier to treat or cure. By the
time symptoms appear, the cancer may have grown and spread. This can make the
cancer harder to treat or cure.

BREAST CANCER

There are many, often con icting, recommendations surrounding breast cancer screening.
New evidence-based patient-facing breast cancer guidelines from the National
Comprehensive Cancer Network (NCCN) state that women should undergo a breast
cancer risk assessment starting at age 25 years, and they emphasize annual
mammography screening beginning at age 40 years for those with average risk.

1. Clinical breast exam - done by a doctor - once a year

2. Breast self examination - to be done by the person to check their breasts for lumps or
other changes - 4-5 days after periods, every month or alternate month.
3. Mammogram - starting at age 40 yrs. - once a year.
4. MRI Breast - may be used as a screening test for women who have a high risk of
breast cancer.

Women with risk factors for breast cancer, such as certain mutations in the BRCA1 or
BRCA2 genes or certain genetic syndromes may be screened at a younger age and more
often.
Men who have breasts should talk to their doctors about getting screening tests and
contact their doctor if they notice any lump, bloody nipple discharge or any asymmetry.

Women should remember that breast changes can occur because of pregnancy, ageing,
or menopause; during menstrual cycles; or when taking birth control pills or other
hormones. It is normal for breasts to feel a little lumpy and uneven. Also, it is common for
breasts to be swollen and tender right before or during a menstrual period.
It is very important, whenever a woman notices any unusual changes in her breasts, she
should contact her gynaecologist/ physician.

CERVIX CANCER

Generally recommend that testing begin at age 21 and end at age 65 with either option.
1. PAP smear alone - every 3 yrs
2. PAP smear with HPV testing - every 5 yrs
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After age of 65 yrs, no testing is needed if you’ve had regular cervical cancer testing with
normal results during the previous 10 years.
Women with certain risk factors may need to have more frequent screening or to
continue screening beyond age 65. These risk factors include - HIV infection, being
immunosuppressed, having being treated for a precancerous cervical lesion or cervical
cancer.
Screening not required for women who have had a total hysterectomy (surgery to remove
the uterus and cervix) and have no history of precancerous cervical lesions or cervical
cancer.

Although most women with cervical cancer have the HPV infection, not all women with an
HPV infection will develop cervical cancer.
HPV infections are spread mainly through sexual contact. Women who become sexually
active at a young age and have many sexual partners are at increased risk for HPV
infections.

HPV can also play a role in other types of cancer, such as cancers of the anus, vagina,
vulva, penis, and oropharynx.

Even if you have taken HPV vaccine, still you should get cervix cancer screening.

COLORECTAL CANCER

Generally recommend that people who are at average risk for colorectal cancer have
screening with one of these tests from ages 45 or 50 through 75 yrs.
1. Colonoscopy - every 10 years
2. Sigmoidoscopy - every 5 to 10 years
3. Stool occult blood test - every 1-2 years
4. Stool DNA test - every 3 years

People who are at increased risk of colorectal cancer because of a family history of
colorectal cancer, excessive alcohol use, obesity, being physically inactive, cigarette
smoking or documented advanced polyps or because they have IBD ( in ammatory
bowel disease) or certain inherited conditions (such as Lynch syndrome and familial
adenomatous polyposis) may be advised to start screening earlier and/or have more
frequent screening.

LUNG CANCER

Screening may bene t if you smoke now or smoked before (quit within the past 15
years), and have a 20 pack-year smoking history. (A pack-year is 1 pack of cigarettes per
day per year. One pack per day for 20 years or 2 packs per day for 10 years would both
be 20 pack-years.)

Low dose spiral CT scan is recommended to be done every year for such people from
age of 50 to 80 yrs.
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PROSTATE CANCER

A PSA test or a DRE (Digital rectal examination) may be able to detect prostate cancer at
an early stage, but it is not clear whether early detection and treatment decrease the risk
of dying from prostate cancer.
Also, in addition to prostate cancer, the PSA level tends to increase with age, prostate
gland size (Benign prostate hyperplasia), and in ammation (prostatitis) or infection.

Prostate cancer screening is recommend for men from age of 40-45 to 70 yrs. who are at
higher risk of prostate cancer - Black men, men with mutations in BRCA2 or in BRCA1
genes, and men whose father or brother had prostate cancer.
Starting at age 50 yrs, all men should discuss with their doctor about the potential bene ts
of prostate cancer screening.

OVARIAN CANCER

The CA-125 blood test together with TVS (trans-vaginal ultrasound), may be used to try to
detect ovarian cancer early, especially in women with an increased risk of the disease -
family history of ovarian cancer, mutations in BRCA1 or BRCA2 genes.

P.S. - These are general guidelines for Cancer Screening as of 8th August, 2022, with
references from National Comprehensive Cancer Network (NCCN), National Cancer
Institute, USA and American Cancer Society.
If you have a family history or other high risk factors for any cancer, please consult your
physician or an oncologist for more information.

Stay Healthy Stay Happy! 😊

Dr. Nikhil Aggarwal

General Physician (MBBS)

hello@drnikhilaggarwal.com
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