Cancer Screening entails tests and exams designed to identify cancer in individuals who do not exhibit symptoms. Detecting cancer at its early stages significantly enhances treatment outcomes, as it allows for prompt intervention before the disease progresses. According to the American Cancer Society (ACS), early detection through screening plays a pivotal role in reducing mortality rates associated with colorectal, breast, cervical, lung (especially among individuals with a history of heavy smoking), and prostate cancers. At the outset, any screening should be done after consultation and proper discussion with an oncologist.
- Breast Cancer screening – Breast cancer stands as the most prevalent cancer globally and the second most common among women in Nagaland. Detecting breast cancer early, while it remains localized and manageable, is crucial for successful treatment. Regular screening tests constitute the most reliable method for early breast cancer detection. Women aged 40 to 44, with an average risk of breast cancer, are encouraged to consider annual mammograms. For women aged 45 to 54, yearly mammograms are recommended, while those aged 55 and older can opt for biennial screenings. Screening should continue for as long as a woman remains in good health and is expected to live another ten years or more. Women at a high risk, indicated by a family history of cancer or genetic predisposition, should commence screening with MRI and mammograms before the age of 40 and continue as long as they are in good health.
- Oral Cavity screening – Individuals with a history of tobacco consumption in any form, including smoking or chewing, are strongly advised to undergo oral cavity screening. This entails a clinical examination of the oral cavity and neck to detect any abnormalities, along with a Nasopharyngolaryngoscopy (NPLscopy) to inspect the aerodigestive tract for any growths. Smokers and individuals who consume alcohol are particularly susceptible to head and neck cancers.
- Colorectal Cancer screening – Regular screening significantly reduces the incidence of colorectal cancer and facilitates its early detection, rendering it more treatable. Individuals aged 45 or older, with an average risk(not previously been diagnosed with CRC, adenomatous polyps, or inflammatory bowel disease and who do not have a personal or family history of hereditary cancer predisposition syndromes), should undergo regular colorectal cancer screenings. Various effective screening methods are available, including colonoscopy, flexible sigmoidoscopy, and at-home stool tests for abnormal fecal DNA or blood. Those at a higher risk(colorectal cancer in three or more relatives, one of whom is a first-degree relative of the other two; Colorectal cancer involving at least two generations; One or more colorectal cancers diagnosed below the age of 50 years)may require earlier or more frequent screenings or specific tests. In cases where an abnormal result is obtained from a non-colonoscopy screening test, prompt follow-up with colonoscopy is imperative.
- Prostate Cancer screening – The decision to screen men for prostate cancer involves weighing potential benefits against risks. Men should engage in informed discussions with healthcare professionals to make this decision. Men at average risk, aged 50 and above with an expected lifespan of at least ten more years, should discuss screening options with their healthcare provider. Men with multiple family members diagnosed before the age of 65 should begin discussions by the age of 40.
- Cervical Cancer screening – The HPV test, which identifies HPV infections that could lead to cervical cancer, can be conducted either independently or alongside a Pap test. Cervical cancer screening is recommended for women at average risk, starting at the age of 25. Those aged 25 to 65 should undergo primary HPV testing every five years. Alternatively, screening can be performed every five years with a co-test (combining HPV and Pap tests) or every three years with a Pap test alone. Individuals over 65, with no history of pre-malignant cervical lesion in the past 25 years and with regular screening within the past decade yielding normal results, may discontinue screening. However, individuals vaccinated against HPV should adhere to these guidelines. Moreover, those who have undergone a total hysterectomy should cease screening, except in cases where the cervix remains intact.
- Lung Cancer screening – Annual low-dose CT (LDCT) scanning for lung cancer may be considered for individuals at a higher risk who meet specific criteria. This screening method significantly reduces the risk of lung cancer mortality. Screening is recommended for individuals aged 50 to 80 who are current smokers or have quit within the last 15 years, with a smoking history of at least 20 pack-years. They should have received counseling for smoking cessation if currently smoking, be informed about the potential benefits and limitations of LDCT screening, and undergo screening at a facility experienced in lung cancer management.
- Skin Cancer awareness – Skin cancer affects people across all demographics. There are no specific screening guidelines, but it is crucial for individuals to be vigilant about their skin health. Regular self-examinations can aid in the early detection of skin cancer, enhancing treatment efficacy. Monthly self-checks to monitor moles, blemishes, and other skin irregularities is recommended. Additionally, individuals at a higher risk, such as those with compromised immunity or a family history of skin cancer, should undergo regular skin examinations by healthcare professionals.
April , which marks Head and Neck Cancer Awareness Month, CIHSR has since been providing complimentary oral cavity screening at the ENT OPD on the first three Saturdays of the month. Secure your appointment promptly to take advantage of this opportunity for screening. Remember, prevention is always preferable to cure!
Dr.Vishala Rose Marie
Varghese, Radiation
Oncologist, CIHSR, Dimapur