American Cancer Society Announces Guidelines For The Early Detection Of Cancer - Update

Thu. March 06, 2008; Posted: 12:00 AM

(RTTNews) - Wednesday, American Cancer Society released its first consensus guidelines on cancer screening for those people at average risk for cancer and also for those without any specific symptoms.

The Society said people who are at increased risk for certain cancers may need to follow a different screening schedule, such as starting at an earlier age or being screened more often. The Society said those with symptoms that could be related to cancer should see their doctor immediately.

For people aged 20 or older having periodic health exams, a cancer-related checkup should include health counseling, and depending on a person's age and gender, might include exams for cancers of the thyroid, oral cavity, skin, lymph nodes, testes, and ovaries, as well as for some non-malignant, non-cancerous diseases.

The Cancer Society recommended special tests for certain cancer sites. To screen breast cancer the Society recommended yearly mammograms starting at age 40 and continuing for as long as a woman is in good health. Clinical breast exam should be part of a periodic health exam, about every 3 years for women in their 20s and 30s and every year for women 40 and over.

The Society recommended six screening tests for spotting signs of colon cancer. Beginning at age 50, both men and women at average risk for developing colorectal cancer should use flexible sigmoidoscopy every 5 years, colonoscopy every 10 years double contrast barium enema every 5 years, and CT colonography every 5 years. Tests that mainly find cancer fecal occult blood test every year, fecal immunochemical test every year and stool DNA test.

The Society said all women should begin cervical cancer screening about 3 years after they begin having vaginal intercourse, but no later than when they are 21 years old. Screening should be done every year with the regular Pap test or every 2 years using the newer liquid-based Pap test.

Women who have had a total removal of the uterus and cervix may also choose to stop having cervical cancer screening, unless the surgery was done as a treatment for cervical cancer or pre-cancer. Women who have had a hysterectomy without removal of the cervix, the Society said, should continue to follow its guidelines.

The American Cancer Society said that at the time of menopause, all women should be informed about the risks and symptoms of endometrial uterine cancer, and strongly encouraged to report any unexpected bleeding or spotting to their doctors. For women with or at high risk for hereditary non-polyposis colon cancer (HNPCC | news | PowerRating | PR Charts ), annual screening should be offered for endometrial cancer with endometrial biopsy beginning at age 35.

The Cancer Society said both the prostate-specific antigen (PSA | news | PowerRating | PR Charts ) blood test and digital rectal examination (DRE | news | PowerRating | PR Charts ) should be offered every year, beginning at age 50, to men who have at least a 10-year life expectancy. Men at high risk should begin testing at age 45. Men at even higher risk, due to multiple first-degree relatives affected at an early age, could begin testing at age 40.

Information should be provided to all men about what is known and what is uncertain about the benefits, limitations, and harms of early detection and treatment of prostate cancer so that they can make an informed decision about testing.

The Society said men who ask their doctor to make the decision on their behalf should be tested. Discouraging testing was not appropriate. Also, not offering testing was not appropriate.

"The challenge we have is getting people to participate in screenings," said Jack Mandel, an Emory University epidemiologist who has studied colon cancer screening tests. "We can prevent these deaths."

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