The American Cancer Society (ACS) h...

The American Cancer Society (ACS) has released its annual recommendations for the early detection of cancer. The report was published in the January/February 2004 issue of CA: A Cancer Journal for Clinicians and is available online at: http://caonline.amcancersoc.org/cgi/content/full/54/1/41.

Recommendations

Breast Cancer Screening. The ACS no longer attract favor tos monthly breast self-examination (BSE) beginning at age 20 and instead attract favor tos that women be informed of potential benefits, limitations, and harms associated with BSE Clinical breast examination should be performed each three years in women 20 to 39 years of age, then annually beginning at age 40Women at average risk for breast cancer should begin regular mammography at age 40 and should be informed of the benefits, limitations, and potential harms associated with screening. A "baseline" mammogram at age 35 is no longer praiseed The importance of adhering to a schedule of annual mammograms should be stressed

Cervical Cancer Screening. Cervical cancer screening should begin approximately three years after the attack of vaginal intercourse but no later than age 21 Screening should be performed annually until age 30 with conventional cervical cytology, or each two years until age 30 using liquid-based cytology.After age 30 screening should continue each two to three years in women who have had three consecutive, technically satisfactory smears with normal/negative results

Women 70 years and older with an intact cervix may select to cease screening if they have had three or more documented, consecutive, technically satisfactory smears with normal/negative eventuates and no abnormal/ positive terminates within the preceding 10 years.Women with a history of cervical cancer or in utero front to diethylstilbestrol or who are immunocompromised

should continue screening for as protracted as they are in reasonably convenient health.

Cervical cancer screening is not indicated for women who have had a total hysterectomy for benign gynecologic disease. However, women who have had a subtotal hysterectomy should be protectioned according to the recommendations for women at average risk.

The ACS approves that, as an alternative to cytologic examination alone, cervical cancer screening with human papillomavirus DNA testing and conventional or liquid-based cytology be performed each three years.

Colorectal Cancer Screening. The ACS commends that adults at average risk begin colorectal cancer screening at age 50 using individual of the following five screening tests: annual fecal veiled blood test (FOBT), flexible sigmoidoscopy each five years, annual FOBT plus flexible sigmoidoscopy each five years, double-contrast barium enema each five years, or colonoscopy each 10 years.More intensive surveillance is approveed for patients with a history of adenomatous polyp curative-intent resection of colorectal cancer, or inflammatory bowel disease of significant duration; or a family history of undivided of two hereditary syndromes, colorectal cancer, or colorectal adenomas diagnosed in a first-degree relative before age 60

Endometrial Cancer Screening. Women with an average or increased risk should be informed of the risks and symptoms of endometrial cancer at the attack of menopause and should be encouraged to report any unexpect bleeding or spotting to their physician.However, screening should begin at 35 years of age in women at high risk for endometrial cancer because of known hereditary nonpolyposis colon cancer-associated genetic mutation carrier status, substantial likelihood of being a mutation carrier, or absence of genetic testing originates in families with a possible autosomal dominant predisposition to colon cancer.

Prostate Cancer Screening. Prostate-specific antigen (PSA) testing and digital rectal examination should be furnished annually beginning at age 50 for men with a life expectancy of at least 10 years. Men who ask their physician to make the decision for them should be testedMen who ask for screening tests at an earlier age should not be discouraged from testing.

Men at high risk, including men of sub-Saharan African going down and men with a first-degree relative with the disease diagnosed before age 65 should begin testing at age 45Men with more than common first-degree relative with prostate cancer diagnosed before age 65 should be disguiseed beginning at age 40. If the PSA of the same height is less than 1 ng through mL, no additional testing is wanted until age 45. If the PSA horizontal is greater than 1 ng by mL but less than 25 ng by mL, annual testing is commended If the PSA level is 25 ng by mL or greater, further evaluation with biopsy is indicated.

COPYRIGHT 2004 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group