Release date: 2017-08-18

The 2017 US Cancer Report shows that overall cancer mortality has fallen by 25% over the past two decades. Among them, the promotion of cancer screening is indispensable. In the past half century, the mortality rate of cervical cancer in the United States has been declining, and the effectiveness has also benefited from the popularity of Pap and HPV examinations.

So, is screening useful for all cancers?

of course not. Every cancer is different and cannot be generalized.

Let's first look at what is cancer screening.

The so-called "screening" refers to a physical examination before symptoms occur in order to discover a certain disease. In the United States, an examination method for clinical cancer screening must have the following points:

Effectiveness and specificity, relatively sensitive to the discovery of certain cancers and precancerous lesions

Safety, no obvious side effects

Operable, economical and convenient for screening large numbers of people

On this basis, it is necessary to support the research data for several years, how to interpret the screening results, the frequency of screening, and the treatment methods. All of this requires regular review and timely adjustment.

Which cancers have a clear screening method?

The US Centers for Disease Control and Prevention (CDC) recommends following the guidelines developed by the USPSTF. What is the USPSTF? The US Preventive Services Task Force.

This is an independent organization founded in 1984. It is made up of well-known experts in disease prevention and evidence-based medicine in the United States, providing guidance on disease prevention screening. Authorized by Congress in 1998, it was taken over by the US Medical Research and Quality Control Department. Report to Congress every year, in addition to recommending disease screening guidelines, report gaps in disease prevention services found, and recommend issues that need to be addressed first.

The following four cancers, CDC and USPSTF have clear screening guidelines.

Breast cancer

(1) Applicable people

Women with a general risk of 50 to 74 years of age have a mammogram every 2 years.

Women between the ages of 40 and 49 are advised to discuss with their doctors, consider the patient's family history, personal risks, and weigh the pros and cons.

(2) Screening means

X-ray angiography (mammography): Studies have shown that conventional X-ray angiography can reduce the risk of dying from breast cancer.

Nuclear Magnetic Resonance (MRI): Nuclear magnetic resonance is generally used with X-ray angiography. Because sometimes MRI has some false positives, it is only suitable for high-risk groups.

Cervical cancer

(1) Applicable people

Women between the ages of 21 and 65.

(2) Screening means

Pap smear and HPV testing. These two screenings can effectively detect early lesions and promptly intervene to block the development of cancer.

Lung cancer

(1) Applicable people

The following three conditions must be met:

Heavy smoking history (with specific criteria)

Still smoking or quit smoking in the past 15 years

Between 55 and 80 years old

(2) Screening means

Low dose spiral CT

(3) Screening for lung cancer has stricter control, mainly due to the following factors:

Screening may have false positives, meaning that a person who does not have cancer itself is diagnosed with cancer

May cause overdiagnosis and lead to overtreatment

Repeated low-dose CT may lead to cancer in healthy people

(4) say one hundred times

The best way to reduce the risk of lung cancer is not to screen, but to quit smoking and avoid secondhand smoke. Lung cancer screening is definitely not a substitute for smoking cessation. This cannot be overemphasized in any way.

The decline in lung cancer mortality in the United States is closely related to efforts to control tobacco control in the 1960s, to ban smoking in public, and to increase tobacco taxes.

If you don't care about yourself, can you do it without making second-hand smoke for your child?

Colorectal cancer

Almost all colon cancers have evolved from precancerous lesions for more than a decade. Screening is primarily the discovery and removal of these precancerous lesions, which in turn block possible cancers. Early detection and early treatment of colorectal cancer is also effective.

(1) Applicable people

Regular screening starts at age 50, regardless of gender. Screening is essential for preventing colon cancer. All people between the ages of 50 and 75 are recommended for screening. 76 to 85 years old, talk to your doctor.

The following populations recommend screening before the age of 50:

Self or immediate family members have polyps or colon cancer

Have an inflammatory bowel disease, such as ulcerative enteritis or Crohn's disease

Suffering from APC or HNPCC syndrome

(2) Screening means

A variety of screening methods, colonoscopy is done approximately every 10 years.

Other cancer

Although there are some methods for examination of ovarian cancer, prostate cancer and skin cancer, the current examination methods are not sensitive to specific early diagnosis, and can not effectively reduce the mortality caused by these cancers, so it is not recommended as a medical routine.

Other cancers that are not mentioned are even more viable methods of examination, not to mention effective early screening.

Conclusion

1. Cancer screening varies from cancer to cancer and varies from person to person. Some cancers (breast cancer, cervical cancer, lung cancer, colorectal cancer) can be effectively screened, early detection and early treatment, and the effect is beyond doubt. More cancer, there is no effective screening method.

2. The United States has clear guidelines and management for each cancer screening. Under the premise of following the guidelines, doctors adjust the situation of each patient to avoid over-examination and over-treatment.

3. Cancer screening is undoubtedly an attractive sunrise industry, but without scientific guidance and strict management, it will inevitably become a chaotic vegetable market.

Source: Tumor time

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