Cancer Detection
Breast cancer
Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health. Clinical breast exam (CBE) should be part of a periodic health exam, about every 3 years for women in their 20s and 30s and every year for women 40 and over.
Women should know how their breasts normally feel and report any breast change promptly to their health care providers. Breast self-exam (BSE) is an option for women starting in their 20s.
Women at high risk (greater than 20% lifetime risk) should get an MRI and a mammogram every year. Women at moderately increased risk (15% to 20% lifetime risk) should talk with their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram. Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is less than 15%.
*MEN: Breast cancer occurs mainly in women, but men can get it, too. Possible signs of breast cancer to watch for include:
Gentlemen, these changes aren’t always caused by cancer… Still, if you notice any breast changes, you should see your health care professional as soon as possible.
Cervical cancer
All women should begin cervical cancer screening about 3 years after they begin having vaginal intercourse, but no later than when they are 21 years old. Screening should be done every year with the regular Pap test or every 2 years using the newer liquid-based Pap test.
Beginning at age 30, women who have had 3 normal Pap test results in a row may get screened every 2 to 3 years. Another reasonable option for women over 30 is to get screened every 3 years (but not more frequently) with either the conventional or liquid-based Pap test, plus the HPV DNA test. Women who have certain risk factors such as diethylstilbestrol (DES) exposure before birth, HIV infection, or a weakened immune system due to organ transplant, chemotherapy, or chronic steroid use should continue to be screened annually.
Women 70 years of age or older who have had 3 or more normal Pap tests in a row and no abnormal Pap test results in the last 10 years may choose to stop having cervical cancer screening. Women with a history of cervical cancer, DES exposure before birth, HIV infection or a weakened immune system should continue to have screening as long as they are in good health.
Women who have had a total hysterectomy (removal of the uterus and cervix) may also choose to stop having cervical cancer screening, unless the surgery was done as a treatment for cervical cancer or pre-cancer. Women who have had a hysterectomy without removal of the cervix should continue to follow the guidelines above.
Endometrial (uterine) cancer
The American Cancer Society recommends that at the time of menopause, all women should be informed about the risks and symptoms of endometrial cancer, and strongly encouraged to report any unexpected bleeding or spotting to their doctors. For women with or at high risk for hereditary non-polyposis colon cancer (HNPCC), annual screening should be offered for endometrial cancer with endometrial biopsy beginning at age 35.
Ovarian Cancer
Unfortunately, there is no regular screening recommended for women at average risk of ovarian cancer. However, that does not mean that women should not be vigilant about seeing a doctor if they experience symptoms that may indicate ovarian cancer.
The most common symptoms of ovarian cancer include:
- bloating
- pelvic or abdominal pain
- trouble eating or feeling full quickly
- urinary symptoms such as urgency (always feeling like you have to go) or frequency (having to go often)
Other symptoms that have been reported by women with ovarian cancer include:
- fatigue
- upset stomach
- back pain
- pain during sex
- constipation
- menstrual changes
Most of these symptoms can also be caused by other less serious conditions, but when the symptoms are caused by ovarian cancer they tend to be more severe and are a change from how a woman usually feels. Prompt attention to symptoms may improve the odds of early diagnosis and successful treatment. See a gynecologist immediately if you have had these symptoms daily for a few weeks.
For women at high risk of ovarian cancer (strong family history of ovarian cancer or BRCA gene mutation), there are two tests that are used most commonly to screen for ovarian cancer: ransvaginal sonography and CA-125.
Transvaginal sonography is an ultrasound test that places a small instrument in the vagina. It can help find a mass in the ovary, but it can’t actually tell which masses are cancers and which are not.
CA-125 is a protein in the blood that is higher in many women with ovarian cancer. The problem with this test is that conditions other than cancer can also cause high levels of CA-125. In addition, someone with ovarian cancer can still have a normal CA-125 level.
In studies of women at average risk of ovarian cancer, these screening tests did not lower the number of deaths caused by ovarian cancer. For this reason, transvaginal sonography and the CA-125 blood test are not recommended for ovarian cancer screening of women without known strong risk factors.
References
American Cancer Society. Cancer Facts & Figures 2008. Atlanta, Ga: American Cancer Society; 2008.
http://www.cancer.org/docroot/PED
http://www.cancer.org/docroot/CRI
