Chapter 078. Prevention and Early Detection of Cancer (Part 8)

Screening for Specific Cancers Widespread screening for cervical, colon, and likely breast cancer is beneficial for certain age groups. A number of organizations have considered whether or not to endorse routine use of certain screening tests. Because these groups have not used the same criteria to judge whether a screening test should be endorsed, they have arrived at different recommendations. The U.S. Preventive Services Task Force (USPSTF), the Canadian Task Force on Preventive Health Care, and the American Cancer Society (ACS) publish screening guidelines (Table 78-3). Special surveillance of those at high risk for a specific cancer because of...
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Chapter 078. Prevention and Early Detection of Cancer (Part 8) Chapter 078. Prevention and Early Detection of Cancer (Part 8) Screening for Specific Cancers Widespread screening for cervical, colon, and likely breast cancer isbeneficial for certain age groups. A number of organizations have consideredwhether or not to endorse routine use of certain screening tests. Because thesegroups have not used the same criteria to judge whether a screening test should beendorsed, they have arrived at different recommendations. The U.S. PreventiveServices Task Force (USPSTF), the Canadian Task Force on Preventive HealthCare, and the American Cancer Society (ACS) publish screening guidelines (Table78-3). Special surveillance of those at high risk for a specific cancer because of afamily history or a genetic risk factor may be prudent, but few studies haveassessed the influence on mortality. Table 78-3 Screening Recommendations for Asymptomatic Normal-Risk Subjectsa Test or USPSTF ACS CTFPHCProcedure Sigmoidoscopy Fair ≥50, Fair evidence to evidence to every 5 years consider recommend Fecal occult ≥50, good ≥50, Good evidence,blood testing evidence for every year age ≥50 every 1–2 years Colonoscopy No direct ≥50, No direct evidence every 10 years evidence Digital rectal No No Noexamination recommendation recommendation recommendation Prostate- Insufficient M: ≥50, Recommendationspecific antigen evidence to every year against recommend Pap test F: 18–65, F: with Fair evidence to every 1–3 years uterine cervix, include in examination beginning 3 of sexually active years after first women intercourse or by age 21. Yearly for standard Pap; every 2 years with liquid test. Pelvic No F: 18–40, Not consideredexamination recommendation, every 1–3 years advise adnexal with Pap test; palpation during >40, every year exam for other reasons Breast self- No ≥20, Fair evidence toexamination recommendation monthly exclude Breast clinical Insufficient F: 20–40, F: 50–69, everyexamination evidence as a every 3 years; 1–2 years stand-alone >40, yearly without mammography Mammography F: 40–75, F: ≥40, F: 50–69, every every 1–2 years every year 1–2 years (fair evidence) Complete skin Insufficient Periodic Poor evidence toexamination evidence for or exam include or exclude against a Summary of the screening procedures recommended for the generalpopulation by U.S. Preventive Services Task Force (USPSTF), the AmericanCancer Society (ACS), and the Canadian Task Force on Prevention Health Care(CTFPHC). These recommendations refer to asymptomatic persons who have norisk factors, other than age or gender, for the targeted condition. Note: F, female; M, male.