How & When to Get Screened for Cancer

Janet Tiberian Author
By Janet Tiberian, MA, MPH, CHES
February 12, 2021
prevent cancer

How to Get Screened for Cancer & When: Talk to Your PCP

“You have cancer” are three words you never want to hear. The dreaded disease is associated with grueling treatments and claims more than 600,000 American lives each year. But there is some good news: United States cancer deaths rates fell by 2.4 percent between 2017 and 2018. This is a record amount and contributes to an overall 31 percent plummet since 1991, which equals about 3.2 million fewer deaths, according to the American Cancer Society's 2021 Cancer Statistics report. 

Most of the progress is due to a significant drop in lung cancer deaths, followed by breast, colorectal and prostate cancer deaths, the four most commonly diagnosed cancers.

“Of course, healthcare and public health efforts have helped lower the number of new cancer cases and cancer deaths,” says Bernard Kaminetsky, MD, medical director, MDVIP. 

“We need to thank researchers who developed better screening and diagnostic measures, improved treatment protocols and identified the common causes of many cancers,” says Kaminetsky.

Cancer Screening Information

  • What is cancer screening?
  • Who performs cancer screenings?
  • How often should you get tested?

Types of Cancer and Screening Tests

Many types of cancer don’t produce symptoms until the latter stage of the disease. And when symptoms do appear, often they’re vague -- abdominal pain, cough or fatigue. 

Some cancers, like skin and thyroid, may be caught during a routine physical, while other types require tests. For instance, if you have a history of kidney disease, you should discuss it with your PCP, who may order imaging tests or a urinalysis.

These are the tests you should discuss with your PCP and the appropriate age for most people (if you have a history of these cancers in your family, you should have the conversation earlier):

Cancer Type Test Age Frequency

Lung

Source: U.S. Centers for Disease Control and Prevention
Low Dose CT Scan
55-80 with history of heavy smoking or currently smoke or have quit with the last 15 years
Annually

Prostate

 

 

 

 

 

Sources: Johns Hopkins Medicine, University of Texas/MD Anderson Cancer Center

Prostate Antigen Assessment (PSA) and Digital Rectal Exam (DRE)

 

 

 

 

 

 

40-54 if you have a first degree relative with a history of prostate cancer; have at least two extended family members with history of prostate cancer; or are African American

 

 

Otherwise…

55-75

 

76+ 

 

Annually

 

 

 

 

Annually

 

Discuss with doctor

 

Breast 

Source: American Cancer Society

 

Mammogram w/ breast screening

 

 

40-44

45-54

55+

 

Choice to begin annually

Annually

Every 2 years

 

Colorectal

Source: University of Texas/MD Anderson Cancer Center 

Colonoscopy

 

Sigmoidoscopy

 

CT Colonoscopy

 

Stool-based tests

 

50–75; 45-75 for African Americans

 

 

Every 10 years

 

Every 5 years

 

Every 5 years

 

Every 3 years

Cervical

 

 

 

Source: American Cancer Society

Pap Smear 

and

HPV test

 

or

Pap Smear/HPV Test cotest

 

 

25-65

 

 

 

Every 3 years

 

Every 5 years

 

Every 5 years 

If you notice early signs of cancer, talk to your PCP. Here’s a frequently used mnemonic to help you remember the seven common signs of cancer.

Change in bowel or bladder habits 
A sore that doesn’t heal
Unusual bleeding or discharge
Thickening or lump in the breast or elsewhere
Indigestion or difficulty in swallowing
Obvious change in a wart or mole
Nagging cough or hoarseness

What Causes Cancer?

Cancer is a group of diseases characterized by disorderly cell division. Most cells contain DNA, the blueprint for cellular reproduction. Cells reproduce as needed in a specific order and controlled fashion. If a cell becomes damaged, sometimes it cannot repair itself and will begin reproducing new cells without order or control. New cells spun from this damaged cell will continue reproducing in the same abnormal manner. As these cells accumulate, they form a mass of cells (or a tumor) that can spread to surrounding tissues.  

Genes play a role in cellular function. You’ve probably noticed certain cancers run in families. That’s because some genes provide instructions for making proteins that function as tumor suppressors and help repair damaged DNA. BRCA1 and BRCA2 are probably the most well-known genes associated with raising the risk for cancer.  

Cells can also be damaged through environmental factors like UV light and radiation, exposure to toxins such as industrial smoke and asbestos, and lifestyle choices, particularly excessive alcohol consumption and smoking.

“It’s almost impossible to go through life without some cellular damage. This is why it’s important to work with your primary care physician,” says Kaminetsky.

Practice Cancer Prevention

It may be impossible to avoid cellular damage, but you can take steps to help prevent it. Living a healthy lifestyle can help lower your risk for -- possibly even prevent -- certain types of cancer. Here’s an overview of common cancer-prevention behaviors.

Eat a healthy diet. Most people link the typical Western diet -- high in sugar, white flour, saturated fat and processed foods – to cardiovascular and cerebrovascular disease. But studies also link poor dietary patterns to a higher risk for colorectal cancer, prostate cancer, leukemia. Talk to your doctor about following a Mediterranean diet. Many experts believe this dietary style can help prevent cellular DNA damage, lowering the risk for cancer.  

Manage your weight. Obesity can raise your risk for several types of cancers such as breast, colorectal, uterine, esophageal, kidney and pancreatic. If you gain weight, there’s a pretty good chance it will show up in your abdomen. Abdominal fat is consists of many large cells that leave little room for oxygen. The lack of oxygen can trigger low-grade chronic inflammation, which can damage cells. It also can cause an overproduction of insulin and insulin growth factor (IGF-1) levels. Elevated insulin and IGF-1 raise the risk for insulin resistance, which can increase cell production. Additionally, abdominal fat raises estrogen levels, which in turn raise the risk for breast cancer in men and women, and endometrial and ovarian cancers in women.       

Exercise regularly. Obviously, exercise is important because it helps manage weight. In fact, leisure-time exercise is credited with helping lower the risk of 13 types of cancers, according to a study published in JAMA Internal Medicine. The American Cancer Society recommends getting at least 150 minutes of moderate intensity exercise or 75 minutes of vigorous exercise each week.

“If you don’t exercise, these recommendations may seem a little daunting, but for most people, they’re actually quite doable,” says Kaminetsky. “Walking for 30 minutes several times per week at a moderate pace and taking a yoga class will meet the recommendations. Just make sure you talk to your doctor before beginning or changing an exercise program.”

Avoid tobacco. This includes first-hand, second-hand and third-hand tobacco exposure. If you smoke and are ready to quit, talk to your doctor. They can help you find a smoking cessation program and/or prescribe medication or recommend nicotine replacement therapy.  

Limit sun exposure. Skin cancer is the most common form of cancer. Fortunately, you can lower your risk for it by avoiding midday sun, tanning beds and sunlamps. And when you are in the sun, wear tightly woven, loose fitting clothes that cover most of your skin. Don’t forget a hat and sunglasses. Apply a broad-spectrum sunscreen with an SPF of at least 30. And stay in the shade as much as possible.

Discuss the Hepatitis B vaccine with your doctor. Many older Americans are at risk for contracting Hepatitis B (HBV), but don’t realize it. If you are actively dating and have more than one partner, use a condom and discuss the HBV vaccine with your physician. HBV is a sexually transmitted infection (STI) that raises your risk for liver cancer. Other STIs, such as human immunodeficiency virus or human papilloma virus also raise the risk for cancer of the anus, penis, throat, vulva and vagina. 

Schedule an Appointment with your Primary Care doctor for your Next Screening


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About the Author
Janet Tiberian Author
Janet Tiberian, MA, MPH, CHES

Janet Tiberian is MDVIP's health educator. She has more than 25 years experience in chronic disease prevention and therapeutic exercise.

View All Posts By Janet Tiberian, MA, MPH, CHES
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