Cancer screening PROF .MAZIN AL-HAWAZ

Looking for cancer before a person has any symptoms (early detection) Define: Looking for cancer before a person has any symptoms (early detection)

Screening tests For an important, morbid health condition Generally cheap Highly sensitive Not risky There should be a treatment Sensitive: identify almost all of the people who have the condition tested for)

Screening tests Universal screening Case finding Screening all individuals of a certain category (e.g. sigmoidosopy to all above 50) Case finding Screening a small group of individuals based on the presence of risk factors (e.g cancer clusters, family members diagnosed with hereditary disease)

Types of screening tests 1. History and physical exam 2. Laboratory tests by take sample of tissue, blood, urine or other substances of the body 3. Imaging procedures; e.g mamme graphy 4. Genetic tests: looking for gene mutations that lead to cancer.

Goals of screening tests: 1- Find cancer before symptoms appear 2- Screens for cancer that is easier to treat and cure by early detection 3- Has few false negative, false positive results 4- Decrease the chance of dying from cancer

Who needs to be screened 1. Person have had cancer in the past 2. Have two or more first-degree relatives who have had cancer 3. Have certain gene mutations that have been linked to cancer

Advantages of screening tests 1. Improved prognosis 2. Less radical treatment 3- Reassurance for these with negative results 4. Resource saving from less radical treatment

Disadvantages 1. Over treatment of borderline cases 2. False reassurance for with those false negative results 3. Anxiety for those with false +ve result 4. Hazards of screening (x- ray exposure) 5. Resource costs from screening.

Breast Cancer • Yearly mammograms starting at age 40 and continuing for as long as a woman is in good health. • Clinical breast exams (CBE) should be part of a periodic health exam, about every three years for women in their 20s and 30s and every year for women 40 and over. • Women should report any breast change promptly to their health care providers. Breast self-exam (BSE) is an option for women starting in their 20s. • Women at increased risk (e.g., family history, genetic tendency, past breast cancer ) should talk with their doctors about the benefits and limitations of starting mammography screening earlier, having additional tests (e.g., breast ultrasound or MRI), or having more frequent exams.

Colon and Rectal Cancer • Beginning at age 50, both men and women at average risk for developing colorectal cancer should follow one of these five testing schedules: • yearly fecal occult blood test (FOBT)* or fecal immunochemical test (FIT) • flexible sigmoidoscopy every 5 years • double-contrast barium enema every 5 years • colonoscopy every 10 years

Prostate Cancer • Both the prostate-specific antigen (PSA) blood test and digital rectal examination (DRE) should be offered annually, beginning at age 50 to men who have at least a 10year life expectancy. Men at high risk (African-American men and men with a strong family of one or more first-degree relatives (father, brothers) diagnosed at an early age) 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 age40. Depending on the results of this initial test, no further testing might be needed until age45.

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