These guidelines provide a brief overview of cancer screening for the general public. People with a family or personal history of cancer, or with concerns about their risk of cancer, should discuss individual cancer screening recommendations with their doctor. The source for this information is the National Cancer Institute and specialists at Huntsman Cancer Institute.
Early detection of breast cancer dramatically improves the chances of successful treatment. Regular mammograms, yearly breast exams by a healthcare provider, and monthly breast self-exams are the primary screening methods used to detect breast cancer early. A mammogram is an x-ray of the breast tissue that can detect cancer years before a tumor can be felt. During a clinical breast exam, the healthcare provider carefully feels the tissue in the breasts and under the arms to check for lumps or other unusual changes, such as puckering or scaling of the skin. In breast self-examination, a woman should check her breasts for lumps, thickenings, or any other abnormalities. The breast self-exam may complement or increase the effectiveness of the other screenings, but does not replace the need for clinical breast exams and mammograms. It is important to remember that, although most breast lumps are not cancerous, all breast lumps and abnormalities must be evaluated by a medical professional.
- Breast self-exam every month
- Clinical breast exam every year by a healthcare provider
Age 40 and over
- Breast self-exam every month
- Breast exam every year by a healthcare provider
- Mammogram every year
Women who meet any of these conditions may need special testing or screening beginning at an earlier age:
- Previously diagnosed with breast cancer
- Received radiation treatment to the chest
- Have a family history of breast cancer
- Carry BRCA1 or BRCA2 genetic mutations
These women should speak with their healthcare providers to determine recommended breast cancer screening. To schedule a mammogram at HCI, call 801-581-5496.
Cervical cancer is nearly 100% curable when detected in early stages. During the last forty years, the number of deaths due to cervical cancer has decreased by more than 70%, largely due to women getting regular Pap tests. The Pap test is a simple test in which cells are collected from in and around the cervix. The procedure can be done in a few minutes in a healthcare provider's office. Women who have been vaccinated against the human papillomavirus still need regular Pap tests and pelvic exams.
The Pap test is recommended to begin within three years after becoming sexually active, but no later than age 21. It should be continued annually until a healthcare provider determines a different screening schedule is appropriate.
The screening methods for prostate cancer include digital rectal exam, prostate-specific antigen (PSA)blood test, and transrectal ultrasound.
During a digital rectal exam, the healthcare provider inserts a gloved, lubricated finger into the rectum to examine part of the prostate gland for bumps or hard areas. The PSA test is a blood test that can show an abnormally elevated PSA level, which can indicate prostate cancer. Transrectal ultrasound uses sound waves to make an image of the prostate on a video screen. The most effective and accurate prostate screenings involve tests used in combination, rather than tests used alone. Men should discuss which tests are right for them with their doctor.
Age 45 and over
- Men with a family history of prostate cancer and African American men are advised to consider screening beginning at age 45 with a yearly digital rectal exam and PSA blood test.
- Men at general risk for prostate cancer should have a yearly digital rectal exam and PSA blood test beginning at age 50.
Colorectal cancer affects men and women, most commonly after age 50. Cancerous cells usually develop in a polyp, which is a small tissue mass on the colon's surface. Detecting and removing polyps early may cure or even prevent colorectal cancer. The three primary methods used to detect colorectal cancer are stool blood testing, flexible sigmoidoscopy, and colonoscopy.
Stool blood testing checks for red blood cells in the stool (bowel movement) that are not visible to the naked eye. This test consists of smearing a small amount of stool onto special paper and mailing it to a clinic or laboratory, where a chemical that can detect the presence of blood is applied to the paper. Patients may be asked to follow a special diet four to seven days before the stool blood test.
Sigmoidoscopy consists of having a sigmoidoscope—a flexible tube about three-fourths of an inch in diameter that contains a camera—inserted into the anus so the healthcare provider can thoroughly examine the lower part of the colon. Because the procedure can cause air to be inserted into the colon, patients may feel some minor discomfort similar to gas pain.
Colonoscopy detects polyps and tumors in their early stages. In this procedure, the entire colon is examined using a flexible tube with an attached camera (colonoscope). If a polyp is found, it can be removed during the exam. If a tumor or large polyp is found, a small piece of tissue will be removed to determine if it is cancer. Before the procedure takes place, the doctor will provide instructions on how to cleanse the colon to prepare for the exam.
Age 50 and over
- Stool blood test every year
- Sigmoidoscopy with digital rectal exam every five years
- Colonoscopy every five to ten years
Certain groups of people may need special testing because of an increased risk of colorectal cancer. People with one or more of the following should speak with their healthcare providers about the need for more specialized colorectal cancer screening:
- Previous diagnosis of colorectal cancer or polyps
- Inflammatory bowel disease such as ulcerative colitis or Crohn's disease
- Two or more immediate relatives such as a parent, sibling, or child with colon cancer
- One or more relatives diagnosed with colorectal cancer before age 50
- Carriers of familial adenomatous polyposis (FAP), Gardner syndrome, or hereditary nonpolyposis colon cancer (HNPCC)
Some leading cancer organizations have recommended stool DNA tests and virtual colonoscopy as options for colorectal cancer screening. Although both tests have shown promise, Huntsman Cancer Institute recommends continuing with present, thoroughly tested screening approaches until further studies confirm the long-term overall effectiveness of these methods.
Skin Cancer and Melanoma
Skin cancer is the most commonly diagnosed cancer. More than 1 million cases are diagnosed each year. There are three main types:
Regular screening is important for early detection of skin cancer . Screening for skin cancer consists of frequent skin self-examinations. For skin self-exams, a person examines hir or her entire body, checking for irregular moles, lesions, and sores that don't heal.
Suspicious moles may have one or more of the following characteristics:
- Asymmetrical shape
- Border irregularity
- Color difference within a mole
- Diameter equal to or larger than the size of a pencil eraser
- Evolution of a mole (if a new mole develops or if an existing mole changes in size, color, shape, or becomes itchy or bleeds)
Nodules, scaly patches, signs of change or growth in a mole, or any sore that does not heal within four weeks should be reported to a dermatologist. Although the majority of skin abnormalities are not cancerous, they should be evaluated by a dermatologist.
A person with any concerns should talk with his or her dermatologist about when to begin skin exams, how to perform skin self-exams, and how often a clinical skin exam is needed. Ideally, a person would perform a skin self-exam monthly and have a clinical skin exam annually.
People with any of these conditions may need special early detection measures, such as more frequent skin exams and mole mapping, and should take more precautions to avoid sunburns:
- A personal history of melanoma
- An immediate family member (parent, sibling, or child) with a history of melanoma
- A light complexion, such as red or blond hair, green or blue eyes, or the tendency to sunburn easily
- A blistering or peeling sunburn that occurred before the age of 18
- One or more abnormal moles, which are moles that are 4 mm or more in diameter, partially or completely flat, varying in color, or have irregular or indistinct borders
Three screening tests are available for detecting lung cancer:
- Chest x-ray: This is an x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
- Sputum cytology: This test looks for cancer cells in a sample of sputum (mucus that is coughed up from the lungs).
- Low-dose spiral computed tomography (LDCT) scan: This test uses low-dose radiation to make a series of very detailed pictures of areas inside the body. It uses an x-ray machine that scans the body in a spiral path. The pictures are made by a computer linked to the x-ray machine. This test is also called a low-dose helical CT scan.
These screening tests have been studied to see if they decrease the risk of dying from lung cancer. The following results have been found:
- Screening with LDCT scans has been shown to decrease the risk of dying from lung cancer in heavy smokers.
A lung cancer screening trial studied over 50,000 people aged 55 years to 74 years who had smoked at least one pack of cigarettes per day for 30 years or more and quit within the past 15 years. The trial used chest x-rays or LDCT scans to check for signs of lung cancer.
LDCT scans were better than chest x-rays at finding early-stage lung cancer. Screening with LDCT also significantly decreased the risk of dying from lung cancer.
The National Comprehensive Cancer Network (NCCN) updated its lung cancer screening guidelines in 2011 based on the findings of this trial. However, a low-dose spiral CT scan isn't meant to screen for lung cancer in everyone. A patient and his or her doctor should discuss the risks and benefits of lung cancer screening.
- Screening with chest x-rays or sputum cytology does not decrease the risk of dying from lung cancer.
Chest x-ray and sputum cytology screening tests can help detect lung cancer, but they do not decrease the risk of dying from the disease.
Where to Turn with Questions and Concerns