Chapter 078. Prevention and Early Detection of Cancer (Part 8) potx

Chapter 078. Prevention and Early
Detection of Cancer
(Part 8)

Screening for Specific Cancers
Widespread screening for cervical, colon, and likely breast cancer is
beneficial for certain age groups. A number of organizations have considered
whether or not to endorse routine use of certain screening tests. Because these
groups have not used the same criteria to judge whether a screening test should be
endorsed, they have arrived at different recommendations. The U.S. Preventive
Services Task Force (USPSTF), the Canadian Task Force on Preventive Health
Care, and the American Cancer Society (ACS) publish screening guidelines (Table
78-3). Special surveillance of those at high risk for a specific cancer because of a
family history or a genetic risk factor may be prudent, but few studies have
assessed the influence on mortality.
Table 78-3 Screening Recommendations for Asymptomatic Normal-
Risk Subjects
a

Test or
Procedure
USPSTF ACS CTFPHC
Sigmoidoscopy

Fair
evidence to
recommend
≥50,
every 5 years
Fair evidence to
consider

Fecal occult
blood testing
≥50, good
evidence for
every 1–2 years
≥50,
every year
Good evidence,
age ≥50
Colonoscopy
No direct
evidence
≥50,
every 10 years
No direct
evidence
Digital rectal
examination
No
recommendation
No
recommendation

No
recommendation
Prostate-
Insufficient
M:
≥50,
Recommendation

specific antigen
evidence to
recommend
every year against
Pap test F: 18–
65,
every 1–3 years
F: with
uterine cervix,
beginning 3
years after first
intercourse or

by age 21.
Yearly for
standard Pap;
every 2 years
with liquid test.
Fair evidence to
include in examination
of sexually active
women
Pelvic
examination
No
recommendation,
advise adnexal
palpation during
exam for other
reasons

F: 18–
40,
every 1–
3 years
wi
th Pap test;
>40, every year
Not considered
Breast self-
examination
No
recommendation
≥20,
monthly
Fair evidence to
exclude
Breast clinical
examination
Insufficient
evidence as a
stand-alone
without
mammography
F: 20–
40,
every 3 years;
>40, yearly
F: 50–
69, every
1–2 years

Mammography

F: 40–
75,
every 1–
2 years
(fair evidence)
F:
≥40,
every year
F: 50–
69, every
1–2 years
Complete skin
examination
Insufficient
evidence for or
against
Periodic
exam
Poor evidence to
include or exclude

a
Summary of the screening procedures recommended for the general
population by U.S. Preventive
Services Task Force (USPSTF), the American
Cancer Society (ACS), and the Canadian Task Force on Prevention Health Care
(CTFPHC). These recommendations refer to asymptomatic persons who have no
risk factors, other than age or gender, for the targeted condition.

Note: F, female; M, male.