COLORECTAL CANCER SCREENING

What methods are used to screen for colorectal cancer ?
(1) FOBT - Fecal occult blood test
This test checks for hidden blood in fecal material (stool). It is done Once every year.
Disadvantages - This test fails to detect most polyps and some cancers. False-positive result.

(2) Flexible Sigmoidoscopy
The rectum and lower colon are examined using a lighted instrument called a sigmoidoscope. Precancerous and cancerous growths in the rectum and lower colon can be found and either removed or biopsied. Regular screening with sigmoidoscopy after age 50 can help reduce the death from colorectal cancer. It is done Once every 4 years.
Disadvantages - Any polyps in the upper part of the colon will be missed. There is a small risk of bleeding or tearing/perforation of the lining of the colon.

(3) Colonoscopy
The rectum and entire colon are examined using a lighted instrument called colonoscope.Precancerous and cancerous growths throughout the colon can be found and either removed or biopsied. It is done Once every 2 years.
Disadvantages - Small polyps, nonpolypoid lesions and cancers may not be detected but it is one the most sensitive tests currently available.

(4) Virtual Colonoscopy
Special x-ray equipment is used to produce pictures of the colon and the rectum that can show polyps and other abnormalities. It is done Once every 2 years.
Disadvantages - Small polyps, nonpolypoid lesions and cancers may not be detected.

(5) DCBE - Double contrast barium Enema
A series of x-rays of the entire colon and rectum are taken. DCBE may miss small polyps. It detects about 30 to 50 % of cancers. It is done Once every 2 years.
Disadvantages - Small polyps and cancer may not be detected. False-positive results are possible. During the test, biopsy cannot be performed. Polyps cannot be removed.

(6) DRE - Digital rectal exam
DRE allows examination of only the lower part of the rectum as a routine physical examination.
Disadvantages - Abnormalities only in the lower part of the rectum can be detected.

(7) Stool DNA Test
This test checks your stool for cells that are shed by colon cancers or precancerous polyps.

When should you be screened for colorectal cancer ?
Colorectal cancer is more common in older people, 50 years of age and older. Some people have risk factors that make them to get a colorectal cancer at a young age. Screening should begin earlier in these people.
You should be screened for colorectal cancer at a younger age if:
* you have had colorectal cancer or polyps in the past
* you have a family history of colorectal cancer or polyps
* you have ulcerative colitis or Crohn's disease
* you have a hereditary colon cancer syndrome
* you eat a high-fat, low-fiber diet
If you are in one of these groups, you need to be tested at a young age more than a person who doesn't have risk factors for colorectal cancer.
If you don't have any risk factors for colorectal cancer, you should have your first screening test around 50 years of age.
Any one of the screening programs with DRE at each screening are used, beginning at 50 years of age. There is no minimum age for having a screening colonoscopy.
If you want to do screening, discuss with your doctor what type of screening should you choose ?

TWO HPV VACCINES TO PREVENT CERVICAL CANCER

2 HPV Vaccines are available.
Gardasil vaccine protects against 4 HPV types - 6, 11, 16 & 18.
Cervarix vaccine protects against 2 HPV types - 16 & 18 that are high-risk viruses.
HPV 6 & 11 can cause Genital Warts.
HPV 16 & 18 can cause Cervical Cancer.
High-risk HPV viruses 31, 35 & 45 can cause Cervical Cancer but there is no vaccine for these types of HPV.
Gardasil can provide protection against HPV 16 for 4 years.
Cervarix can provide protection against HPV 16 & 18 for more than 4 years.
Studies are undergoing whether Booster vaccinations are necessary.
HPVs means Human Papillomaviruses that are a group of more than 100 viruses. Over 30 types can be passed from one person to another through sexual contact.
Because the vaccines will not protect against all infections that cause cervical cancer, it is important for vaccinated women to continue to undergo Pap Smear - cervical cancer screening as is recommended for women who have not been vaccinated.

BREAST CANCER SCREENING

Breast Cancer Screening
Two tests are commonly used to screen for breast cancer.
(1) Mammogram
(2) Clinical Breast Exam (CBE)
If a lump or other change is found by mammogram or CBE, follow-up tests may be needed.
Other Screening Tests are
(3) MRI (magnetic resonance imaging)
(4) Tissue sampling
3 methods of tissue sampling are
(a) Fine-needle Aspiration
(b) Nipple Aspiration
(c) Ductal Lavage
Who should do Breast Cancer Screening ?
If Girls/Ladies who have a family history of cancer - they should do Self Exam and CBE at 30.
If Women who have a family history of cancer - they should do Mammogram at 36.
If Women who have No family history of cancer - they should do Self Exam, CBE and Mammogram at 40.

WHAT IS CANCER SCREENING.....?

Screening is looking for Cancer before a Person has any symptoms. This can help find cancer at an early stage.
When abnormal tissue or cancer is found early, it may be easier to treat. By the time, symptoms appear, cancer may have begun to spread.
It is important to remember that your doctor does not think you have cancer if doctor suggests a Screening Test.
Screening tests are given when you have no cancer symptoms. If a screening test result is abnormal, you may need to have more tests done to find out if you have cancer. These are called Diagnostic Tests.

CERVICAL CANCER SCREENING & DIAGNOSIS

Screening & Diagnosis
Regular screening can prevent cervical cancer by detecting abnormal changes in the cervical cells when they are pre-cancerous and can be treated.
Although the knowledge level of pap smear is high, most women are not screened annually.

It is important to detect the disease when it is in the pre-cancerous stage because with proper treatment at this time the cure rate is almost 100 %. The following are the means of detection.
(1) Pap Smear Test
(2) Colposcopy
(3) Cone Biopsy

When should a Pap Smear be done ?
Once a woman is sexually active and repeated after one year. After that, the pap smear can be done annually.

Pap Smear Result
It will indicate whether the smear is normal or abnormal. If you have an abnormal test result, your doctor will advise further investigations such as Colposcopy and Cone Biopsy.

Colposcopy
The cells and distribution of vessels are seen under a binocular microscope. Abnormal distribution of blood vessels and cells can be detected.
A biopsy is taken if abnormalities are found.

Cone Biopsy
Cone Biopsy is done when the upper limit of possible abnormalities cannot be seen by Colposcopy. In pre-cancerous of the cervix, removal of all the abnormal tissues by cone biopsy can be a form of treatment.