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CANCER
SCREENING
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CANCER SCREENING |
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American cancer society guidelines - 2002 for early
detection of cancer in Average risk, asymptomatic
people |
|
|
Cancer
site
|
Population
|
Test
of procedure
|
Frequency
|
| Cancer
related check-up |
Men
and women Age 20+
|
Examinations
every three years from ages 20 to 39 years
and annually after age 40. the cancer related
check-up include examinations for the cancers
of the thyroid, testicles, ovaries, lymph
nodes, oral cavity and skin, as well as health
counseling about tobacco, sun exposure, diet
and nutrition, risk factors, sexual practices
and environmental and occupational exposures.
|
| Breast
|
Women, age 20+
|
Breast
self examination, Clinical breast examination,Mammography
|
Monthly,
starting at age 20, Every 3 years, ages 20-39,
Annual starting at age 40 |
| Colorectal
|
Men
and women Age 50+
|
Fecal
occult blood test (FOBT) and Flexible sigmoidoscopy
or Flexible sigmoidoscopy or FOBT or colonscopy
or Double contrast barium eneme |
Annual
FOBT and flexible sigmoidoscopy every 5 years,
starting at age 50 Annual, starting at age
50 Colonscopy every 10 years starting at age
50 Every 5 years, starting at age 50 |
| Prostate
|
Men,
age 50+
|
Digital
rectal examination (DRE) And Prostate specific
antigen (PSA) |
The
PSA and DRE should be offered annually, starting
at age 50, for men who have a life expectancy
of at least 10 years. |
| Cervix
|
Women,
age 18+
|
Pap
test and pelvic examination |
All
women who have been sexually active of have
reached age 18 should have an annual Pap test
and pelvic examination. After a woman has
had 3 or more consecutive normal annual examinations,
the frequency of PAP test may be reduced at
the discretion of the physician. |
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American cancer society guidelines - 2002 on screening
and surveillance for the early detection of colorectal
adenomas and cancer women and men at increased risk
or high risk
|
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|
Risk
category
|
Age
to begin
|
Recommendation
|
Comment
|
|
INCREASED
RISK |
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|
| People
with single, small (< 1cm) adenoma |
3-6 years after the
initial polypectomy
|
Colonscopy
|
If
the exam is normal, the patient can thereafter
be screened as per average risk guidelines
|
| People
with a large (1 cm +) adenoma, multiple adenomas,
or adenomas with high grade dysplasia or villous
change. |
Within
3 years after initial polypectomy
|
Colonscopy
|
If
normal, repeat exam in 3 years; If normal
then, the patient can thereafter be screened
as per average risk guidelines |
| Personal
history of curative-intent resection of colorectal
cancer |
Within
1 year after resection
|
Colonscopy
|
If
normal, repeat exam in 3 years; If normal
then, repeat examination every 5 years |
| Either
colorectal cancer or adenomatous polyps, In
any first degree relative before age 60, or
in two or more first degree relatives at any
age (if not a hereditary syndrom) |
Age
40, or 10 years before the youngest case
in the immediate family
|
Colonscopy
|
Every
5-10 years. Colorectal cancer in relatives
more distant than first degree does not increase
risk substantially above the average risk
group. |
|
HIGH
RISK
|
|
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|
| Family
history of familial adenomatous polyposis
(FAP) |
Puberty
|
Early
surveillance with endoscopy and counseling
to consider genetic testing |
If
genetic test is positive, colectomy is indicated.
These patients are best referred to a centre
with experience in management of FAP |
| Family
history of Hereditary non-polyposis colon
cancer (HNPCC) |
Age
21
|
Colonscopy
and counseling to consider genetic testing
|
If
the genetic test is positive or if the patient
has not had genetic testing, every 1-2 years
until age 40, then annually. These patients
are best referred to a center with experience
in the management of HNPCC |
| Inflammatory
bowel disease Chronic Ulcerative colitis Crohn's
disease |
Cancer
risk begins to be significant 8 years after
the onset of pancolitis, or 12-15 years
after the onset of left-sided colitis.
|
Colonscopy
with biopsies for dysplasia |
Every
1-2 years. These patients are best referred
to a centre with experience in the surveillance
and management of inflammatory bowel disease. |
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