New Routine Cancer Screening Recommendations: 2007
Donald Aulds, M.D.
Within the past couple of months the American College of Obstetricians and Gynecologists has published 2007 recommendations for cancer screening. Since cancer is the second leading cause of death in women in this country, it is important that women are aware of the recommendations and take a role in maintaining their health. Early detection of a cancer is the best defense and improves the treatment capability and decreases death rates. The recommendations discussed are for the average-risk women not women with high-risk for one of the cancers discussed. If a woman is at high-risk the screening precautions should be discussed with their physician.
In 2006, data for the incidence of new cases of cancer was tabulated and the following information was published:
TYPE OF CANCER |
NUMBER OF NEW CASES PER YEAR |
Breast cancer |
212,920 |
Lung cancer |
81,770 |
Colorectal cancer |
75,810 |
Endometrial cancer |
41,200 |
Skin cancer |
30,420 |
Ovarian cancer |
20,180 |
Cervical cancer |
9,710 |
In comparison, the death rate from lung cancer is the highest of all cancers in women, with nearly twice as many deaths from lung cancer than breast cancer.
Suggested routine cancer screening guidelines:
- General health – all women should have a health evaluation annually that should include an evaluation for cancer to detect premalignant or malignant conditions.
- Breast cancer – Mammography is recommended every 1-2 years between 40-50 and yearly after age 50. Screening should include an annual breast exam as part of the physical examination. Self-breast exam has the potential of detecting masses and then further testing can be done.
- Cervical cancer – Cervical cytology (pap smear) should be done annually starting after the onset of sexual intercourse or no later than age 21 in a women who is still a virgin. There is information circulating about having pap smears every 2-3 years but this is only after having at the minimum of three consecutive normal annual pap smears or having a pap smear and HPV testing in combination that is normal. It is up to the patient to discuss this with their physician.
- Colorectal cancer – Beginning at age 50, one of the following options should be selected: 1. Yearly patient-collected fecal occult blood testing (FOBT) or fecal immunochemical testing (FIT); 2. Flexible sigmoidoscopy every 5 years; 3. Yearly patient-collected FOBT or FIT plus flexible sigmoidoscopy every 5 years; 4. Double-contrast barium enema every 5 years; or 5. Colonoscopy every 10 years.
- Endometrial cancer – screening for women without symptoms of endometrial cancer is not recommended at this time.
- Lung cancer – Screening tests for lung cancer is not recommended as testing techniques are not cost-effective and do not reduce death rates from the cancer
- Ovarian cancer – Currently, there is not an effective technique for routine screening of low-risk women without symptoms. Regular physical examinations and monitoring for symptoms are the best defense at this time.
- Skin cancer – skin evaluation by a physician who is comfortable with skin examination should be done regularly for exposure to ultraviolet ray damage.
Please discuss these with your physician, and formulate a program for monitoring that fits your lifestyle and your desire.
More about Dr. Aulds
Donald G. Aulds, MD is an Obstetrician and Gynecologist and currently serves as the Medical Director for both the Women's Center and the Best Start Program of North Alabama. He is a Diplomat of the American Board of Obstetrics and Gynecology and Fellow of the American College of Obstetricians and Gynecologists.
Dr. Aulds completed his medical education at Louisiana State University School of Medicine, New Orleans, LA and his Internship and Residency in Obstetrics and Gynecology at Ochsner Medical Foundation, New Orleans, LA.
Dr. Aulds has been an active member of the Huntsville Hospital Medical Staff since 1980.
