The American College of Physicians is offering advice on a very tough topic. The ACP is providing guidance on screening the average adult for five common cancers. The group wants people to be more informed about screenings for the five most common cancers: breast, colorectal, ovarian, prostate, and cervical.
The ACP wants people to review the guidelines for each and to understand that most screenings don't take place annually. In fact, some are recommended at five-year intervals.
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Dr. Dale Shepard, who did not take part in the creation of the recommendations, but treats cancer patients at Cleveland Clinic, says the advice here is that less-frequent screenings are much better than no screenings at all.
"What they've done is come up with recommendations, which oftentimes are a little different than what we've seen in the past, and its less-frequent screenings. So, if we can get the right people to screen, even if it's at a less-frequent basis we're more likely to have success," Shepard explained.
Shepard says early detection is critical and following screening guidelines will help to catch cancers early.
"So, the key to actually effective treatment of cancer is catching things early and that's through screening," Shepard added.
Screening for Cancer: Advice for High-Value Care From the ACP
(Information From Table 1. High- and Low-Value Screening Strategies for 5 Types of Cancer*)
Breast:
- Women aged 40–49 y: Discuss benefits and harms with women in good health, and order screening with mammography every 2 y if a woman requests it
- Women aged 50–74 y in good health: Encourage mammography every 2 y
- Women aged <40 or ?75 y and women of any age not in good
health and with a life expectancy <10 y: Any screening - Women of any age: Annual mammography, MRI, tomosynthesis, or
regular systematic breast self-examination
Cervical:
- Women aged 21–29 y: Cytology testing every 3 y
- Women aged 30–65 y: Cytology testing every 3 y or cytology and HPV testing every 5 y
- Women aged <21 or >65 y with previous recent negative screening
results: Any screening - Women of any age without a cervix: Any screening
- Women aged 21–65 y: Cytology testing more frequently than every 3 y
- Women aged <30 y: HPV testing
- Women of any age: Pelvic examination
Colorectal:
- Adults aged 50–75 y: Encourage 1 of the 4 following strategies: High-sensitivity FOBT or FIT (every year); sigmoidoscopy (every 5 y); combined high-sensitivity FOBT or FIT (every 3 y) plus sigmoidoscopy (every 5 y); or optical colonoscopy (every 10 y)
- Adults aged <50 or >75 y or adults of any age not in good health
and with a life expectancy <10 y: Any screening - Adults aged 50–74 y: Repeated colonoscopy more frequently than
every 10 y or flexible sigmoidoscopy every 5 y if results of previous colonic examination were normal (i.e., without adenomatous polyps) - Any age: Interval fecal testing in adults having 10-y screening
colonoscopy or more frequently than biennially in adults having
5-y screening flexible sigmoidoscopy
Ovarian:
- Women of any age: CA-125 screening, TVUS, or pelvic examination
Prostate:
- Men aged 50–69 y: Discuss benefits and harms of screening with men in good health with a life expectancy >10 y at least once (or more as the patient requests), order screening only if the informed man expresses a clear preference for screening, and order PSA testing no more often than every 2–4 y
- Men aged 50–69 y who have not had an informed discussion and
have not expressed a clear preference for testing after the discussion: PSA testing - Men aged <50 y or >69 y and men of any age who are not in good
health and have a life expectancy <10 y: Any testing
(CA-125 = cancer antigen 125; FIT = fecal immunofluorescence testing; FOBT = fecal occult blood testing; HPV = human papillomavirus; MRI = magnetic resonance imaging; PSA = prostate-specific antigen; TVUS = transvaginal ultrasonography.
* This table provides information for persons at average specific cancer risk who do not have severe competing risk for mortality from another
condition. The least intensive recommended strategies are the minimal ones recommended by high-visibility medical groups and guideline
organizations (high value). The strategies that are not recommended represent general agreement among groups and signify low-value screening.
The rationale for not recommending strategies usually involves an unfavorable tradeoff between benefits and harms, a type of value calculation, but
does not include costs. Strategies that are not recommended are more intensive than recommended strategies.)
Read the complete list of cancer-screening guidelines from the American College of Physicians.