What is cancer screening?

Cancer screening involves using tests to find people who may be at risk of a specific type of cancer, even though they have no symptoms. The main goal is to catch cancer early or find pre-cancerous changes, making treatment more effective and improving survival rates. It helps catch cancer before it reaches more difficult stages that are difficult to treat.

Screening is usually recommended for cancers where finding the disease early leads to better outcomes. Examples include mammograms for breast cancer, Pap smears and HPV tests for cervical cancer, fecal occult blood tests (FOBT) and colonoscopies for colorectal cancer, and low-dose CT scans (LDCT) for lung cancer in people at high risk.

Organizations like the American Cancer Society and the American Society of Clinical Oncology offer guidelines for when and how often to screen, depending on age and risk factors. For instance, they suggest starting colorectal cancer screening at age 45, with options like a colonoscopy every 10 years or a yearly FOBT.

While screening can save lives, it can also have downsides, such as false positives (finding something that turns out not to be cancer), overdiagnosis, and stress from the screening process. Expert groups like the U.S. Preventive Services Task Force (USPSTF) continually review the evidence to make sure the benefits outweigh the risks.

Types of screenings available

Cancer screening involves different types of tests designed to detect cancer early, often before symptoms appear, improving the chances of successful treatment. Several screening methods are available for common cancers, each tailored to specific types of cancer. For breast cancer, mammograms are widely used to identify abnormal growths in breast tissue. For cervical cancer, Pap smears and HPV testing are recommended to detect changes in cervical cells. Colorectal cancer screening options include stool tests like the fecal occult blood test (FOBT) and colonoscopy, which can detect and remove polyps before they become cancerous. Additionally, low-dose CT scans are used to screen for lung cancer in high-risk individuals, such as heavy smokers. Each of these tests plays a crucial role in reducing cancer mortality by finding cancers at an early, more treatable stage.

People with a family history of cancers can consider getting germline genetic testing to see if they have predisposition to developing inheritable forms of cancer.  Another emerging trend is use of circulating tumor DNA to detect for asymptomatic cancers. For both of these tests, it’s important to speak with your physician to determine if they would be of value to your personal healthcare.

 

What are the types of cancer screening that are available for men?

Colorectal Cancer

Fecal Occult Blood Test (FOBT) and Fecal Immunochemical Test (FIT): can be performed every year starting at age 45[3]
Colonoscopy: Low risk people can have a colonoscopy performed every 10 years starting at age 45.[3]
Flexible Sigmoidoscopy (FSIG): can be performed every 5 years, or every 5 years combined with annual FIT.[3]
CT Colonography: can be performed every 5 years starting at age 45.

Lung Cancer

Low-Dose Computed Tomography (LDCT): can be performed every year in people who are at high risk for lung cancer, like those aged 55 to 74 who currently smoke or used to smoke a lot (for example, smoking a pack of cigarettes a day for 30 years).

Prostate Cancer
Prostate-specific Antigen (PSA): a blood test used to detect prostate cancer. It remains controversial as to whether or not it should be done routinely in the male population. Multiple associations recommend that men age 55 to 69 years old should consider for PSA screening, but it is a shared decision between the doctor and the patient. Some guidelines now recommend starting PSA screening in Black men at age 40 – 45.

 

What are the types of cancer screening that are available for women?

Breast Cancer
Mammography: can be performed every year to every other year starting at age 40 in most normal risk women.
Cervical Cancer
Pap Test (Papanicolaou Test) and HPV testing: Women age 21 to 29 should have a Pap test every 3 years. Women aged 25 to 29 can consider HPV testing, but Pap tests are the better choice. Women aged 30 to 65 have three options for testing: they can get both a Pap test and an HPV test every 5 years, have just a Pap test every 3 years, or get HPV testing alone every 5 years.
Colorectal Cancer
Fecal Occult Blood Test (FOBT) and Fecal Immunochemical Test (FIT): can be performed every year starting at age 45[3]
Colonoscopy: Low risk people can have a colonoscopy performed every 10 years starting at age 45.[3]
Flexible Sigmoidoscopy (FSIG): can be performed every 5 years, or every 5 years combined with annual FIT.[3]
CT Colonography: can be performed every 5 years starting at age 45.

Benefits of cancer screening

Cancer screening offers many benefits in terms of public health value including increasing treatment options and reducing insurance expenditures.

Public Health Value: Screening for cancer can lower the number of deaths from cancer and help keep people healthy. For example, studies show that following screening guidelines for breast, colorectal, cervical, and lung cancers could save between 12.2 and 16.2 million life-years in the U.S. This means a lot of people would live longer! Early detection is key because it allows for better treatments and helps people survive longer.

More Treatment Options: When cancer is found early through screening, there are usually more treatment choices, and they can be less harsh. For example, women who get regular mammograms are more likely to catch breast cancer early, which means they might not need tough treatments like chemotherapy or possibly even surgery. Similarly, finding colorectal cancer early can allow doctors to remove growths before they turn into cancer.

Insurance Coverage: Most insurance covers cancer screenings which help reduce disparities in cancer outcomes. The Affordable Care Act (ACA) says that these tests have to be covered without extra costs, which helps more people get screened. For example, when health insurance covers colorectal cancer screening, more people get tested, which can save lives. Lung cancer screening can also save lives and is often not too expensive.

 

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