Cancer Screening: Why it’s better to be diagnosed early

Cancer – the word alone strikes fear in most people’s heart. But what if we told you that you could screen for the presence of the cancer gene even before you see any symptoms?

Certain cancers do have a familial link (Hereditary cause) and getting screening tests regularly may help you find breast, cervical and colorectal cancers early.

This is essential, as the early detection of these cancers can help treatment work the best.

As per Dr. Vijay Sharnangat, Hemato-oncology and Hematology at Sunrise Oncocare, “Cancer screening is employed in general population where there is a definitive survival benefit.”

The Center for Disease Control (CDC) recommends that people who are at high risk of suffering from lung cancer also get screened regularly⁽¹⁾.  Dr Vijay adds, “Lung cancer is the most commonly seen cancer across the world in men and women. Both sexes can be screened equally with a focus on those people who have a history of more than a 30 packs per year smoking habit.”

Cancer Prevention

So, here’s everything you need to know about cancer screening:

While the exact criteria for getting screened for cancer is still ambiguous. The 3 R’s of cancer screening are Risk factors, Recommendations and Rationale—by cancer type. Here’s a breakdown based on the type of cancer:

Breast cancer

Risk factors: In the case of breast cancer, women are categorized as high, moderate or low-risk.

You’d be considered high risk if you have the following:

• A family history of breast and/or ovarian cancer. This would include two or more close (blood relatives) who have been diagnosed before the age of 50
• If you have any of the following inherited genetic mutations: BRCA1, BRCA2, CDH1, PALB2, PTEN or Tp53
• If your breast biopsy shows atypical cells, lobular carcinoma in situ or atypical lobular hyperplasia.

You’d be considered at moderate risk if you have the following  are considered moderate risk if you have:

• Dense breasts
• A family history of breast cancer in distant relatives, especially if diagnosed in their 50s

You’d be considered at average risk if you have the following:

• Are in good health
• With no family history of breast cancer

The leading cancer organizations differ on screening guidelines. So a good rule of thumb, if you have a family history of breast cancer, is to get tested 10 years before the onset of the disease in your relative.

As per Dr Vijay, “When it comes to screening for breast cancer CBE (Clinical breast examination) and SBE (Self breast examination) should not be promoted. Instead a mammogram should be advised, especially for women from the high risk category.”

Esophageal cancer

Risk factors: Caucasian men, older than 50 years of age and those who are smokers or have either severe acid reflux or Barett’s esophagus.

Recommendation: As per the ACS, high-risk patients should have regular upper endoscopy.

Cervical cancer

When it comes to the early detection and screening for cervical cancer, a Pap smear is your best bet.

It is a routine swab of the cervical region performed at the doctor’s office and is the most reliable and effective cancer screening tests available ⁽²⁾ according to the ACS.

Dr Vijay adds, “ In the case of cervical cancer, screening should be started after 21 years in women who are at high risk (immunecompromised) people, and average risk (immunocompetent) women after 25 years of age. It can be done via a PAP smear every 3 years or a PAP smear and reflex HPV testing every 5 years.”

Risk factors: You’re at risk of developing cervical cancer if you have a history of:

• Smoking
• Multiple sexual partners
• More than 3 childbirths
• Long-term use of birth control pills (five years or longer)
• HPV
• HIV or another condition that compromises the immune system

Recommendations: As per the USPSTF:

For women between 21 to 65 years of age: You should get a pap smear every three years

For women between the age of 30 to 65:  Combined testing of Pap smear and HPV testing every 5 years.

What happens if a screening shows positive results?

In case your cancer screening test shows a positive result, your pathologist and doctor will type and stage it in order to plan your treatment. That being said, cancer screening does have a certain rate of false positives, so it is best to talk to your doctor about it.

Risks of screening

Although cancer screening helps diagnose cancers at an early stage for better treatment outcomes, screening does come with its own risks. Here they are:

Overdiagnosis: A screening test may find a slow growing cancer,  that may be harmless. But as a result could be put through painful, potentially harmful, expensive and stressful treatments that they may not have needed.

False positives: Sometimes a screening test may suggest you have cancer when you do not.

Increased testing: In some cases of a false positive or overdiagnosis, you may be required to undergo a multitude of tests that may not really be necessary. This can be stressful, expensive and physically invasive.

False negatives: Just like false positive results, you could also get a false negative result where you may not be diagnose correctly.

References

1)https://www.cdc.gov/cancer/dcpc/prevention/screening.htm

2) https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/cervical-cancer-screening-guidelines.html#:~:text=Cervical%20cancer%20testing%20(screening)%20should,test%20alone%20every%203%20years.

3) https://www.cancer.gov/about-cancer/screening/screening-tests

4) https://www.who.int/cancer/detection/variouscancer/en/

5) https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/cervical-cancer-screening-guidelines.html#:~:text=Cervical%20cancer%20testing%20(screening)%20should,test%20alone%20every%203%20years.

6) cancer.gov/about-cancer/screening