Save Your Life With Cancer Screening (Part 4)

Most people don’t need to be screened unless they are at high risk, because it has no tproved to be effective, and most cancers found without screening are curable

Most people don’t need to be screened unless they are at high risk, because it has no tproved to be effective, and most cancers found without screening are curable

Most don’t need the test unless they are at the highest risk, because the cancer is uncommon in nonsmokers and the test is not very accurate

Most don’t need the test unless they are at the highest risk, because the cancer is uncommon in nonsmokers and the test is not very accurate

Smoking, a family history of the disease, and long-term exposure to radon, asbestos, or arsenic.

See a doctor if you notice suspicious changes in the color, size, shape, or number of moles.

A visual exam of your skin by a physician looking especially for signs of melanoma, the deadliest form of skin cancer.

Most adults don’t need the exam unless they are at high risk, because the effectiveness of screening has not been proved. But see a doctor if you notice suspicious changes in the color, size, shape, or number of moles.

A family history of melanoma, a personal history of frequent sunburns, a large or increasing number of precancerous moles, and being fair-skinned or heavily freckled.

Keep away from risk factors: Smoking, chewing tobacco, excessive alcohol consumption…

Most people don’t need the test unless they are at high risk, because the cancer is relatively uncommon.

Smoking, chewing tobacco, excessive alcohol consumption, HPV infection, and weakened immunity from medication, disease, or certain other causes.

Men age 50 to 74 should all with a doctor to see whether the benefits of the test outweigh the harm for them based on their risk factors older men rarely need the test because the cancer typically progresses so slowly that treatment does not improve survival. Younger men should consider testing only if they are at high risk, because the cancer is uncommon before age 50.

A transvaginal ultrasound or the CA-125 blood test, which measures a protein possibly associated with ovarian cancer.

Women don’t need to be tested unless they are at high risk, because neither test is likely to detect the disease at a curable stage.

A family history of ovarian, breast, or colon cancers, and possibly use of estrogen after menopause for more than five years

People don’t need to be tested unless they are at high risk, because no test is likely to detect the disease at a curable stage.

A family history of the disease, smoking, obesity, and possibly type 2 diabetes.

Men don’t’ need to be tested unless they are at high risk, because most cancers found without screening are curable.

Colon-cancer screening: just do it

Of the estimated 52,000 people who died of colorectal cancer last year, screening could have saved more than half, according to the American Cancer Society. Yet around 40 percent of people 50 and older don’t get recommended screening tests

Not surprising, our readers, who tend to be a health-savvy bunch, do better than that, according to a survey of more than 10,000 subscribers 50 and older conducted by Consumer Reports National Research Center. Eighty percent of them had been screened for colon cancer in the last five years. But our survey also found worrisome gaps in their knowledge of the tests used.

Success Story: For Tracy Doss, colon-cancer screening allowed doctors to detect and remove precancerous growths.

For example, less than half of them were told what the test was looking for, about a third weren’t told of potential complications and a quarter weren’t told what would happen if the tests had abnormal results. Only 10 percent of people who had colonoscopy or sigmoidoscopy, invasive forms of testing that use a scope to inspect the colon, were told there was a simpler option. And only 55 percent were told of the main risk of the procedures, a perforated colon.

Las, some patients got tests that are not proved effective, including fecal DNA tests and CT colonography (also called virtual colonoscopy). That’s unfortunate, because there are a number of good colon-cancer tests to choose from. The chart below shows the pros and cons of each.

Test	How it works	Cost	Advantages	Disadvantages
Colonoscopy Every 10 years; starting at age 50. Sooner or more often for some high-risk people or if result are abnormal.	Long, flexible scope is passed through the rectum and entire colon to look for polyps and tumors.	$1,120	Allows immediate removal of polyps and biopsies; shows entire colon; needs to be done just once a decade for most	Risk of bowel infection, perforated bowel, and other complications; requires full-day preparation with laxatives and dietary restriction; sedation required; full-day recovery likely.
Flexible sigmoidoscopy every five years, with stool test (below) every three years.	Short, flexible scope is inserted into the lower colon to look for polyps and tumors.	$740	No sedation required; can return to work same day; simpler bowel preparation than for colonoscopy; fewer complications than for colonoscopy	Colonoscopy required if positive; shows only the lower third of the colon, so not as thorough as colonoscopy
Stool testing (immunochemical or guaiac-based) Every year.	Detects traces of blood in stool from tumors and polyps that tend to bleed	$5 to $25	Noninvasive; lowest risk of complications; samples are taken at home.	Colonoscopy required if positive; can’t detect most polyps; requires yearly testing; some people might find the test unpleasant.

Risks and benefits of two tests

The data below show that the risks of prostate-cancer screening probably outweigh the benefits and that the benefits of breast-cancer screening are smaller than many women may suspect.

· 3 serious complications caused by treating the cancer, including death, heart attacks, and blood clots in the legs or lungs

An unknown number of complications from breast-cancer treatment, including infection, nausea, and exposure to radiation, which may itself cause cancer. Starting screening at age 40 instead of 50 will prevent one additional death but cause an additional 470 false positives and an additional 33 unneeded biopsies