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Recommended Cancer Screenings

women gathered for breast cancer awareness
June 22, 2015 (Updated: August 16, 2018)
Lily Moran

Last week, I told you about the important roles that diet and exercise play in reducing the risk of cancer. But that’s only part of the story. You’re not truly being proactive with your health if you’re forgoing regular cancer screenings.

Yes, they’re inconvenient, uncomfortable, and in some cases, a little embarrassing, but regular screenings can help you detect certain cancers early, when they are most easily treated and cured. For women, this means breast and cervical cancer tests; and for men and women, colorectal cancer tests. (While screenings for other some other cancers exist, they have not been found to be nearly as effective at reducing cancer mortality.)

While everyone should be getting these simple tests as recommended, researchers at the Centers for Disease Control and Prevention (CDC) found that overall, screening rates continue to drop. In 2013, at least 20 percent of adults were not up to date with the recommended cancer tests. Specifically:

  • 20 percent of women were not up to date with cervical cancer screening;
  • 25 percent of women were not up to date with breast cancer screening;
  • 40 percent of adults were not up to date with colorectal cancer screening.

I find this shocking and, quite frankly, irresponsible—especially considering insurance covers these screenings (usually at 100 percent). And for those who remain uninsured, clinics across the country offer cancer screenings for no or minimal cost.

Currently, the US Preventive Services Task Force recommends the following schedule:

  • Colorectal cancer: Starting at age 50 using either fecal occult blood testing (yearly), sigmoidoscopy (every five years), or colonoscopy (every 10 years).
  • Cervical cancer: Start at age 21 using a Pap test, every three years.
  • Breast cancer: Starting at age 50 using mammography, every two years.

Obviously, these are general guidelines. Recommendations can vary greatly based on family or personal history, genetic variables, and other risk factors such as HPV infection, which dramatically raises the risk of cervical cancer.

Overall, I fully support regular Pap testing and colorectal cancer screenings. I work closely with all of my patients to come up with an appropriate schedule based on their unique health histories. I think the benefits of the tests used to screen for cervical and colorectal cancer far outweigh any minimal risks.

And for patients at especially high risk for other forms of cancer, or who have an abnormal initial screening, I order additional testing, such as ONCOblot, a blood test that can identify the presence of 26 types of cancer.

However, my views on mammography are much more mixed.

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Downsides of Mammography

Mammography remains controversial. While most experts agree that it’s an important screening tool, some recent studies have exposed some very real downsides.

First, a mammogram’s sensitivity (how good it is at detecting suspicious tissue) varies. In premenopausal women with denser breast tissue, the test’s sensitivity is less than 70 percent. That means that at least 30 percent of tumors are missed! A mammogram’s sensitivity improves the older a woman gets, but it’s definitely far from perfect.

On top of that, research has revealed that for every death that it prevents, mammography leads to “overdiagnosis” in three to four women. This means that the screening finds a suspicious area that would have eventually been found by other means, without any effect on prognosis; or that the mammogram detects a suspicious area that would never have affected a woman’s health if it had never been found (in other words, a false positive). In fact, over a 10-year period, the collective risk of false positive results was 61 percent! This leads to countless unnecessary biopsies and surgeries.

Then, of course, there’s the issue of radiation. Mammography exposes you to low-dose radiation, which (ironically) can increase your risk of cancer!

Mammograms do have their place in women’s health, but there are much safer, more accurate breast cancer screening tools out there. One of these is thermography.

Thermography provides a digital infrared image of the breast. Abnormal changes in the breast are noted as pockets of “heat.” When a technician notices such changes, they can keep an eye on it over time. Cancerous growths tend not to “cool down,” which signals the need for further examination. Since thermography doesn’t involve radiation, an unusual spot can be reevaluated as often as necessary to monitor its behavior, without any additional risk.

Fortunately, mainstream medicine is finally starting to agree. A study published in 2014 concluded, “Thermography turns out to be a very useful tool for screening. Because it is non-contact, pain free, radiation free, and comparatively portable, it can be used in as a proactive technique for detection of breast carcinoma.”

For all of these reasons, I usually recommend that my patients alternate between getting mammography and thermography. Doing so lessens radiation exposure and provides two very different pictures of the breasts and their changes over time.

Whether you’re a man or woman, please don’t be part of the minority that ignores the need for cancer screenings. Prevention and early detection are truly priceless.

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