Chapter 4 Screening Tests: Cancer
Content provided by the Faculty of the Harvard Medical School
Chapter 4: Screening tests
Part of cancer prevention is to screen (look) for cancer before symptoms are noticed. In many cases, screening tests can find cancer early, when it is most treatable. Some tests are designed to detect early cancers while others find precancerous changes. The Pap test is a good example. By scraping a few cells from the cervix (the lower part of a woman's uterus, where the uterus connects to the vagina), any precancerous changes can be found and treated before they lead to cancer.
Certain screening tests - such as those for cancer of the cervix, bowel, or breast, including mammography - are of clear value. Colon screening, for instance, reduces colon cancer deaths by roughly half. However, other tests, such as lung x-rays to screen for lung cancer have not produced useful results.
The PSA test for prostate cancer, for example, is controversial because elevated levels of PSA may indicate the presence of prostate cancer or it may point to some entirely different, noncancerous condition, such as an enlarged prostate. Conversely, a normal PSA reading doesn't rule out prostate cancer, particularly in younger men. In general, an elevated PSA only means that further tests are needed. Nevertheless, regular PSA screening is recommended by some major health organizations and many doctors.
Doctors consider a test to be valuable if it provides important information for treatment decisions. But if a test does not provide information to help treat the disease and reduce the number of deaths, few experts would view it as necessary or worthwhile.
The American Cancer Society (ACS) has made specific recommendations for the screening of individuals without particular symptoms. Although other organizations sometimes suggest more or less frequent examination schedules, most agree on the value of regular screening.
| American Cancer Society recommendations for early detection of cancer in people without symptoms | |
| Site | Recommendations for people at average risk |
| Breast |
|
| Colon/Rectum | Men and women ages 50 and older should discuss and choose the optimal early detection method with a health professional. The most commonly recommended tests and schedules include:
|
| Prostate | Men age 50 and older should discuss the pros and cons of yearly PSA blood tests and digital rectal examinations. Tests may start at age 45 for men at high risk** |
| Uterus |
|
| * Other health organizations recommend an annual mammogram after age 50 in healthy women. ** High-risk men include African Americans and men with two (or more) close relatives with prostate cancer. | |
As you plan your cancer prevention strategy, keep in mind that many of the steps that you can take to lower your risk for getting one form of cancer will also lessen your chance of getting others. Making healthful choices will not guarantee good health, but the chances of avoiding disease are greater. Moreover, in making healthful choices, many people have found that they feel better and look better, too.
Chapter 4: Screening tests: 1 of 1
| Last updated: | May 01, 2008 |
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Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.
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