Why You Should Get Screened for These Top Cancers
As a woman, your lifetime risk for all cancers combined is now one in three. Cancer ranks as the second most frequent cause of death for U.S. women, after heart disease. According to the American Cancer Society, in 2014, an estimated 810,000 American women will be diagnosed with cancer, and about 275,000 women will die of some form of the disease. Yet a recent survey found that only about 50 percent of women discussed the pros of cancer screening with their doctors before making a screening decision — still far more than the 15 percent who talked with their doctors about the cons of screening.
If your doctor isn't talking with you about cancer screening, make it your job to bring it up at your next visit. Screening tests can be as simple as at-home breast exams or as sophisticated as DNA tests for BRCA gene mutations. Methods like the ones we describe here can catch cancer at early stages and help you to make your personal best health choices.
At-Home Breast Self-Exams
What it is: A breast self-exam is a simple procedure in which you gently feel your own breasts. You may detect any lumps or other changes that could be early signs of tumors. It's best to do the exam at the same time in your cycle each month if you are premenopausal, because breasts change during your cycle. When you're familiar with what your breasts normally look and feel like, you'll be able to detect changes more easily. To do a breast exam on yourself, follow three easy steps:
- Look in the mirror for any changes, like dimpling or swelling.
- Lie down, and with the pads of your fingers, check each breast and armpit for anything that feels like a new lump or knot.
- Squeeze your nipples to feel for lumps and look for any discharge.
If you find anything unusual, follow up with your healthcare provider right away.
Why you should do breast self-exams: Breast cancer will account for an estimated 29 percent of new cancer cases and 15 percent of cancer deaths among American women in 2014, according to the American Cancer Society. This means it is the second leading cause of cancer death for women. Nearly 3 million U.S. women are living with breast cancer. And according to Johns Hopkins Hospital, about 40 percent of these cancers were found by women who noticed a lump.
Screening Mammograms for Breast Cancer
What it is: A screening mammogram is a type of X-ray that can uncover evidence of breast tumors. Most mammograms are digital, which means they produce more accurate, detailed images; a newer method to increase cancer detection rates is 3D mammography. Starting at age 40, all women should have annual screening mammograms, advocates Otis Brawley, MD, Chief Medical Officer of the American Cancer Society. The U.S. Preventive Services Task Force (USPSTF) calls for mammograms every two years, starting at age 50 but stopping screening after age 75. Talk to your doctor about whether to start at age 40 or 50, based on your own family health history and your cancer risk factors. Find an FDA-approved mammography facilityby entering your zip code.
Why you should have mammograms: Regular mammograms can catch cancer earlier, when treatment may be more effective. The U.S. five-year breast cancer survival rate has risen from 75 percent to 90 percent since 1975, according to the National Cancer Institute. Experts estimate that the 10 percent of the drop in U.S. breast cancer deaths in recent years is due to increased screening. One risk of mammography is a false-positive result — a mammogram that looks abnormal when you do not have breast cancer. This can be anxiety-producing, and can result in expensive and unnecessary tests and treatment.
Genetic Testing for BRCA Gene Mutations
What it is: The BRCA gene mutation test uses blood or saliva samples to detect harmful mutations in BRCA1 or BRCA2 genes, which raise the risk of breast cancer and ovarian cancer in some women. The USPSTF recommends BRCA testing for women with a family history of breast, ovarian, fallopian tube or peritoneal cancers. A positive BRCA test result means you have a 45 to 65 percent risk of developing breast cancer, compared to the 12 percent risk for women overall, according to the National Cancer Institute (NCI). Risk for ovarian cancer rises from 1.4 percent in women overall, to 11 to 39 percent for women with a BRCA mutation. A negative test means you have no high-risk genes, while an ambiguous result — which happens in about 10 percent of BRCA tests — means that your cancer risk is unknown.
Why you should consider BRCA testing: Getting tested for BRCA can give you the peace of mind of knowing your status — whether positive or negative. If your test results are positive, you will be able to make informed choices to reduce your breast cancer risk, such as considering prophylactic mastectomy. On the other hand, BRCA tests can also raise your anxiety levels about cancer risks, not to mention heightening your concern for family members who may carry the genes.
Pap Smear for Cervical Cancer
What the test is: The Pap test for cervical cancer uses a sample of cells to detect changes in your cervix before any symptoms — unusual bleeding, vaginal discharge, orvaginal pain during sex — that could indicate cervical cancer. For the Pap test, also called a Pap smear, the healthcare provider swabs your cervix during your pelvic exam to collect cells, and sends them to a lab. There, technicians look for abnormal cells under a microscope. Pap test results will come in as normal, unclear, or abnormal. An abnormal result means that the cells might become cancerous; if so, you may need more testing, like a colposcopy, a procedure in which a doctor uses a lighted instrument to look for signs of disease in the cervix.
The USPSTF recommends the Pap test for women every three years from age 21 up until age 65. For women who prefer to screen less often, they advise a Pap test once every five years along with an HPV DNA test, from ages 30 until 65.
Why you should have Pap test: According to the National Cancer Institute, Pap tests have resulted in a lower incidence of cervical cancer in the United States. Risks include anxiety about inconclusive results, and overtreatment in younger women in whom cervical cell abnormalities are likely to resolve on their own.
Human Papillomavirus (HPV) DNA Test
What it is: The DNA test for human papillomavirus (HPV) approved for cervical cancer screening is done much like a Pap test, by taking a sample of cervical cells during a pelvic exam. Certain strains of the virus — HPV 16 and HPV 18 — are most likely to cause cervical cancer. If you test positive for one of these, then you will be sent for further testing, such as a colposcopy. If the test shows any of the other 12 HPV strains that are also linked to cervical cancer, then a Pap test is the next step.
The USPSTF recommends HPV DNA tests in combination with the Pap test every five years for women ages 30 to 65, and for women who prefer to screen less often.
Why you should consider the HPV test: The DNA test for HPV is more accurate in predicting cervical cancer, according to the National Cancer Institute. However, the test does have higher rates of false-positive results than the Pap test, because many people carry human papillomaviruses but do not develop cancer. Which cervical cancer screening test you get, Pap or HPV DNA, is not as important as that you get tested, wrote Everyday Health columnist Lauren Streicher, MD. "The majority of the 12,000 women in the United States women who develop cervical cancer each year didn’t have the 'wrong' test," she noted. "The majority of the women who develop cervical cancer had NO test.”
Spiral CT for Lung Cancer Screening
What it is: A spiral CT, or low-dose computed tomography scan, is a more accurate and detailed X-ray of the lungs than a simple X-ray. Smokers or former smokers between 55 and 80 who have a 30 pack-year smoking history should have a yearly spiral CT, recommends the USPSTF. To calculate your pack-year number, multiply the number of packs you smoked per day by the number of years you smoked. A pack a day for 30 years is a 30 pack-year history, and so is two packs a day for 15 years.
The spiral CT test comes with some risks, including a small risk of radiation exposure. Also, it has a relatively high false-positive rate — as many as one-fourth of those tested — which can lead to anxiety as well as unneeded tests and procedures.
Why you should consider spiral CT: While you may think breast cancer is the biggest cancer threat, the most frequent cause of cancer deaths in U.S. women is actually lung cancer. It will account for 13 percent of new cancer cases and about 26 percent of cancer deaths in 2014, according to the American Cancer Society. Taking this preventive care step can be a huge benefit, as screening has cut lung cancer deaths by 20 percent,according to the National Cancer Institute.
Colorectal Cancer Screening
What the tests are: The first screening test for colon cancer is a yearly fecal occult blood test, used to find blood in stool — a possible sign of polyps or other growths in the colon or rectum. For this test, you collect a small stool sample as directed by your doctor, and a lab analyzes it for the blood protein hemoglobin.
If blood is found, your doctor may recommend a colonoscopy. For a colonoscopy, you are under anesthesia while a healthcare worker inserts a lighted tube into your rectum to view the colon and rectum. If a growth such as a polyp is found, a sample is sent to the lab for colon cancer testing. A sigmoidoscopy is a similar procedure, but without anesthesia and with less prep, usually done every three years. Risks of both procedures include colon bleeding, tearing, or perforation. Colonoscopy screening for colorectal cancer should start at age 50 and be done every 10 years unless recommended more often by your doctor, up until age 75, the USPSTF recommends.
Why you should consider these tests: Colon cancer screening should be on your health to-do list because colorectal cancers rank third in cancer-related deaths for U.S. women. Colorectal cancers are expected to account for about nine percent of women’s cancer deaths in 2014, according to the American Cancer Society. Regular screening may lower your risk of dying from colorectal cancer by 60 to 70 percent, the NCI estimates.
Uterine and Endometrial Cancer Detection
What the tests are: If you have any symptoms of uterine or endometrial cancer — abnormal vaginal bleeding, bleeding after menopause, pelvic pain during sex or when urinating — see a doctor, recommends the NCI. A pelvic exam is the first step in finding a cause, and an ultrasound or biopsy could follow, if your physical exam shows evidence of a uterine tumor. An ultrasound creates a picture of your internal organs and any unusual bumps that may be tumors. A biopsy on a uterine tissue sample is the definitive test, in which a lab checks the sample for cancer cells.
Why you should consider uterine cancer tests: Getting diagnosed and treated early can help prevent spread of the cancer to other areas of your body. About 52,630 American women will be newly diagnosed with uterine or endometrial cancer in 2014, most of whom are over the age of 55, according to the American Cancer Society. This is the most common cancer of the reproductive organs for women. More than 600,000 women are living with this type of cancer now, and about 8,590 will die from it in 2014.
Ovarian Cancer Screening
What the tests are: The USPSTF recommends against routine screening for ovarian cancer by ultrasound or by blood tests because these have not proved effective over the years. They do recommend testing if you have symptoms of ovarian cancer, a family history of ovarian cancer, or BRCA gene mutations that can put you at higher risk for ovarian cancer.
Signs of ovarian cancer to watch for are: persistent daily bloating, an urgent need to urinate, and pelvic pain that is unusual for you — symptoms that won't let up for several weeks. Your gynecologist can rule out or detect ovarian cancer with an X-ray image called a computed tomography, or CT scan, or use MRI (magnetic resonance imaging) to look for any unusual lumps or tumors.
Why you should ask about genetic testing for ovarian cancer: In 2014, about 21,980 U.S. women, most over age 60, will find out that they have ovarian cancer. And 14,270 will die from the disease, according to the American Cancer Society. While only 1.4 percent of women overall will ever develop ovarian cancer, the rate is as high 39 percent if you have certain BRCA gene mutations. One benefit of testing for those who have the cancer susceptibility BRCA genes is that you can consider preventive steps, such as having your ovaries and fallopian tubes removed, to lower your risk of dying from this cancer by up to 80 percent.
Skin Cancer Screening
What it is: Screening involves checking your moles, or having a doctor check them, for changes that could be signs of basal cell cancer, melanoma, or squamous cell skin cancer. Although the USPSTF did not find enough evidence to recommend regular screening for skin cancer at home or in your doctor's office, you can take a few simple steps to look for signs of trouble ahead.
If you see any of the ABCDEs of skin cancer when checking your moles, make an appointment with your doctor:
- Asymmetry: One side of your mole is different from the other.
- Border: Your mole's edge has an irregular shape, is scalloped or is not well defined.
- Color: Your mole's color varies, with shades of tan, brown, black, white, red or blue.
- Diameter: You have a mole that's larger than the diameter of a pencil eraser.
- Evolving: Your mole has changed size, shape or color.
Why you should check your moles: Skin cancer is the most common form of cancer diagnosed in the United States, according to the CDC, and rates are on the rise. Over 3.5 million cases of skin cancer are diagnosed every year, the American Cancer Society notes, including both melanoma and basal cell carcinoma.
