Screening Guidelines for Cancer

Women should discuss when they should start annual mammograms with their primary provider based on their age and family breast cancer risk. SSM Health care providers advise women to:

• Discuss with your primary provider if you should have a clinical breast exam (CBE) as part of your annual health exam.
• Though research shows no clear benefit to performing breast self-exams, SSM Health care providers believe that every woman beginning at age 20 should be familiar with how their breasts normally look and feel. Report any changes to a primary care provider right way.
• Mammograms, performed regularly, can help find breast cancer at an early stage. Discuss with your provider at what age you should begin screening with mammography.

If you are at high risk for breast cancer discuss the best timing to begin screenings with your primary provider. Some risk factors include women who:

• Have a lifetime risk of breast cancer 20-25% or greater.
• Have a known BRCA1 or BRCA2 gene mutation.
• Have a parent, brother or sister with a BRCA1 or BRCA2 gene mutation.
• Had radiation therapy to the chest between the ages of 10 and 30 years.
• Have Li-Fraumeni Syndrome, Cowden Syndrome, or Bannayan-Riley-Ruvalcaba Syndrome, or have a first degree relative with one of these syndromes.

Consider genetic testing. Talk with a primary care provider for more information about genetic counseling.

Nearly all cervical cancer is caused by a human papilloma virus, or HPV. There are more than 150 related viruses and some are known to cause cancer. The virus is sexually transmitted and so common that most sexually active adults have or have had an HPV infection at some point in their lives. Talk with your primary provider for cervical cancer screening recommendations.

Because HPV is so common, SSM Health providers recommend a vaccine for girls and boys aged 9-12. Teens and adults can also be vaccinated for HPV. Getting vaccinated against HPV helps protect from a number of cancers caused by HPV infection including cancers of the cervix, throat, vulva, vagina, penis and anus.

Talk with your primary care provider to determine the age at which you should start Colorectal Cancer Screening. Recommendations suggest screening begin at age 45 for men and women with an average risk for developing colorectal cancer. Physicians will recommend one or more of the screening tests below based on family history and health issues:

• Highly sensitive fecal immunochemical test (FIT) every year.
• Colonoscopy every 10 years.
• CT colonography (virtual colonoscopy) every five years.
• Flexible sigmoidoscopy every five years.
• Double-contrast barium enema every five years.

If you have any of the following risk factors for colorectal cancer, screening should begin at an earlier age and be provided more frequently. Your physician will advise you:

• Personal history of colorectal cancer or adenomatous polyps.
• Personal history of chronic inflammatory bowel disease (Crohn’s disease or ulcerative colitis).
• Strong family history of colorectal cancer or polyps.
• Family history of hereditary colorectal cancer syndromes.
• Personal history of radiation to the abdomen or pelvic area prior.

We recommend that at the time of menopause, all women should be informed about the risks and symptoms of endometrial cancer. Report any unexpected bleeding or spotting to your doctor if you are menopausal.

If you have or are at a high risk for hereditary non-polyposis colon cancer (HNPCC), annual screenings should be done for endometrial cancer with an endometrial biopsy beginning at age 35.

Until recently, there wasn’t a screening tool for those that currently smoke, those that used to smoke, those exposed to secondhand smoke, those exposed to environmental factors such as heavy metals or radon in the home. Caught early, lung cancer is highly treatable. But since there are no symptoms, in many cases it’s not discovered until the cancer has become dangerous. Now, your SSM Health primary care provider can help you calculate if the exposure you’ve had in your lifetime puts you at risk of lung cancer.

Screening involves a low dose computed tomography (CT scan) which provides a highly detailed X-ray image of your lungs. The scan takes only a few minutes and is painless. Because these scans use radiation, they are used only when the patient’s calculated exposure indicates they have an elevated risk.

Who should be screened? People who:

• Are between 50-77 years old (Medicare) and 50-80 years old (commercial), and
• Have a 20-pack-year tobacco smoking history, and
• Smoke now or have quit in the past 15 years

Speak with your primary care provider regarding your risk of developing lung cancer.

More than 70% of oral cancers diagnosed today are caused by a human papilloma virus, or HPV. As the use of tobacco has declined, oral cancers from excessive tobacco use including smoking, chewing dip, snuff, and drinking excessive alcohol, have declined. There are more than 150 related viruses and a few of them are known to cause oral cancer. The virus is sexually transmitted and so common that most sexually active adults have or have had an HPV infection at some point in their lives. Healthy individuals usually clear this viral infection on their own. But sometimes the body is unable to clear itself and the result can be cancer.

Our physicians recommend all adults be screened annually. Most dentists now include oral cancer screenings for every adult patient annually. At SSM Health we provide an annual screening as well. Talk with a primary care provider today.

Prostate cancer is a group of cancers that include very slow growing tumors which are common and aggressive cancers that are less common but more dangerous. Screenings have benefits and limitations in early detection. All men should have a discussion with your primary care provider. Review your personal history and level of risk for developing prostate cancer. You and your physician can decide on a screening protocol together.