Cancer Prevention and Screening Guidelines

The American Cancer Society (ACS) estimates that over one million new cases of cancer will be diagnosed in the year 2000; over ½ million people are expected to die of the disease. Cancer remains the second leading cause of death in the United States, following heart disease.

Approximately one-third of these projected cancer deaths could be prevented by lifestyle changes. Many cancers, such as breast, cervical, prostate, colorectal, and skin, are highly curable if detected early. Regular screening is essential for early detection. It is estimated that if all Americans participated in regular screening, the five-year relative survival rate would increase from 80% to 95%.

The Columbia Weill Cornell Cancer Centers endorse the following guidelines and recommendations for screening:

Breast:
Women age 40 and older should have an annual mammogram, an annual clinical breast examination (CBE) by a health care professional, and should perform monthly breast self-examination. Women ages 20-39 should have a clinical breast examination by a health care professional every three years and should perform monthly breast self-examination.

Colon and Rectum:
Beginning at age 50, men and women should have a fecal occult blood test and digital rectal exam every year; and

• A flexible sigmoidoscopy every five years, or
• A colonoscopy every 10 years.

People who are at high risk for colorectal cancer should talk with a doctor about a different testing schedule.

Prostate:
The American Cancer Society recommends that both the prostate-specific antigen (PSA) blood test and digital rectal examination be offered annually, beginning at age 50. Men in high-risk groups, such as those with a strong familial predisposition (i.e. two or more affected first-degree relatives), or of African-American ancestry may begin at a younger age.

Gynecological:
All women who are or have been sexually active or who are 18 and older should have an annual Pap test and pelvic examination. After three or more consecutive satisfactory examinations with normal findings, the Pap test may be performed less frequently. Discuss the matter with your physician. Women at high risk for endometrial or ovarian cancer should talk with their doctor about a different testing schedule.

Lung:
Current smokers over 50 years of age may benefit from an annual spiral CT scan. Former smokers over 50 who quit within the last 20 years may benefit from an annual spiral CT scan.

Skin:
A baseline skin exam is recommended every three years for people between 20-40 years without known risk factors. Annual exams are recommended for people 40 and older, as well as those with risk factors but no history of cancer. Increased frequency may be recommended for those with a history of skin cancer.