Talk about cancer screening
When it comes to cancer color change, it's natural that everyone wants to have a healthy and strong body. Last week, I was invited to give a lecture in the Chinese community on colorectal cancer risk and screening, cervical and breast cancer screening, and good interaction and discussion with the audience. The discussion is also about cancer screening, such as: how to check, when to start, what items to check, where to look, and so on. Many people do not know which cancers can be effectively screened, and some cancers cannot be effectively screened. Some people even asked doctors to arrange annual whole body CT screening, others asked for blood cancer markers screening and so on. Today I use this column to summarize Cancer screening and share it with readers.
What is screening?
Screening is an examination before symptoms appear to detect cancer in the body at an early stage. The test method which can be used as screening must have high sensitivity and specificity at the same time, but also must have safety, maneuverability, economic convenience, can be used for a large number of screening. The designated screening will require years of research data to be supported by periodic reviews and timely adjustments.
Commonly recommended cancer screening tests
According to CDC, CDC supports the U.S. Preventive Services Task Force to recommend screening for four types of cancer, including colorectal, breast, cervical and lung cancer. According to recent data from the Australian Cancer Center, Australia disagrees with lung cancer screening, or low-density CT lung cancer screening.
Colorectal cancer screening
The National Colorectal Cancer screening Program (National Bowel Cancer Screen Program) was co-founded by Australia's government and the state of government, territory government. The program aims to detect colorectal cancer as soon as possible to reduce the number of deaths from colorectal cancer in Australia every year. Send a Colorectal Cancer Test Kit (FOBT test) to eligible people every two years on a regular basis. The examiner collected samples of stool for three days at home and sent them to the specified place according to the instructions of the instructions. The test was simple, painless and cost-free.
-all eligible Australians aged 50 to 74
-screening every two years, male and female
-if you or your immediate family have polyps or bowel cancer, or have inflammatory enteritis, or APC or HNPCC syndrome, you should be able to start screening before the age of 50.
-if you think you may have a higher risk of cancer than the average person, please inform your family doctor so that you can be given a more appropriate examination, such as colonoscopy, etc.
Breast cancer screening
Screening for breast cancer includes self-test, clinical examination, mammography, and MRI.
-Breast self-examination: primarily to raise women's awareness of breast cancer and recommend self-examination at least once a month, usually 7 to 14 days before menstruation
-Clinical mammography: early diagnosis can be improved and mortality reduced. It is generally recommended that when screening for cervical cancer, doctors help you perform breast tests, or combine with molybdenum and palladium screening.
-mammography screening, also known as mammography, is a free government program, a 50-74-year-old general-risk woman, once every two years, but for women aged 40 to 49 who have a family history, they can be discussed with a doctor, It's also a free project.
-Breast MRI: not routine screening programs, mainly breast cancer screening by breast specialists in high-risk groups of breast cancer, especially in patients with BRCA1/2 gene mutations
Cervical cancer screening
Since December 2017, new cervical cancer screening, HPV screening has replaced the traditional cervical smear test, known as the Pap test. The new cervical HPV screening is the detection of HPV infections that may lead to abnormal cell changes.
It is known that persistent HPV infection can lead to changes and abnormalities in cervical cells and may lead to cervical cancer. This usually takes a long time, about 10 years. The new screening for cervical cancer by testing for "HPV" infection can "capture" the culprit that could cause cervical cancer before changes occur in the cervical cells, a significant improvement over Pap's screening. Prematurely block the progression of cervical cancer.
-screening population ages from 25 to 74
-Papillomavirus (HPV) detection every five years
-A letter will be sent through the National Cancer screening Registry inviting women of appropriate age to participate
-it must be stressed that, even with the HPV vaccine, cervical screening is required on a regular basis.
In addition, the cervical cancer vaccine is also an effective means to prevent cervical cancer. 9-valent cervical cancer vaccine Gardasil 9 has been launched throughout Australia. Please consult your doctor.
-recommended Best Age for Gardasil 9: Gardasil 9 is free of charge under the Australian National Vaccine Program, in school for boys or girls, aged between 12 and 13. If you miss the vaccination time, contact your school or your family doctor for a replacement.
-Gardasil 9 has been registered in Australia since 2015, with recommended vaccination age of 9 to 45 for women and 9 to 26 for men
-Gardasil 9 can effectively prevent HPV subtype 6, 11, 16, 18, 31, 33, 45, 52 and 58. Efficiency over 97%
Lung cancer screening
The United States Preventive Services Task Force recommends the screening of lung cancer provided that:
-with a history of heavy smoking,
-smoking now or quitting smoking for the past 15 years
-and people between the ages of 55 and 80
-Annual lung cancer screening using low-dose computed tomography (LDCT)
It should be noted that the screening did not pass in Australia, mainly because of the potential for higher false positives and the increased risk of cancer in healthy people with repeated CT tests. The best way to reduce the risk of lung cancer is to quit smoking and avoid secondhand smoke.
Screening for other types of cance
For the screening of ovarian, pancreatic, prostate, testicular and thyroid cancers, there is currently no effective, highly sensitive and specific means of examination, and it is not possible to achieve the early diagnosis of ovarian cancer, pancreatic cancer, prostate cancer, testicular cancer and thyroid cancer. Nor can they effectively reduce the mortality rate of these cancers.
Can tumor markers be used as a screening tool?
Tumor markers are not suitable for tumor screening because of their low sensitivity and specificity. So far, few tumor markers can be used as a means of tumor screening. Most tumor markers can also be elevated in non-tumor conditions, and not all tumor patients have elevated tumor markers.
Several common tumor markers in clinic
-CA 125, a marker of ovarian cancer, has important implications for early screening, diagnosis and treatment
-PSA, prostate specific antigen
-AFP, alpha-fetoprotein, adjuvant diagnosis and evaluation of therapeutic response to hepatocellular carcinoma
-CEA, embryonic antigen, which can assist in the monitoring of therapeutic efficacy and recurrence of colon cance
-CA 19.9, glycogen antigen for evaluation of therapeutic regimen for pancreatic cancer and gallbladder cance
-CA15.3, for monitoring the therapeutic efficacy and recurrence of breast cance
In short, cancer screening, currently only breast, cervical, and colorectal cancer is determined to be effective at regular screening in order to achieve the goal of early detection, early treatment, and reduction of mortality. But there are no good screening methods for other cancers, including lung, ovarian, pancreatic, and so on. Tumor markers are also not a means of cancer screening. For your health, promote a healthy diet, exercise properly, quit smoking, quit drinking, and experience regular screening.
I hope you all have a healthy and happy life!
References:
https://www.cdc.gov/cancer/dcpc/prevention/screening.htm
www.cancerscreening.gov.au: “ cancer screening”
www.canerscreening.gov.au: “ Lung Cancer screening”
Author: Dr. Ma Chiu-wah
(RACGP) Academician, Royal Australian College of General Practitioners; RACGP Senior Pediatrician; graduated from Fujian Medical University, China, former physician, Fujian Provincial Hospital, China; former resident training, Adelaide Morderbury Hospital, Australia; Five-year specialist training in paediatricians, Adelaide Maternity and Children's Hospital, Australia; tutor, family-based physician, Royal Australian College of General Practitioners; mentor, (Flinders University) Medical Student, Flinders, Australia.
Master in Internal Medicine, surgery, Pediatrics, Gynecology, Prenatal examination, Pediatric Immunization, Geriatrics, chronic Diseases, Travel Medicine, etc. Health medicine columnist
Dr. Ma sat down from Monday to Friday:
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