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

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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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Nội dung Text: 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 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 a family history or a genetic risk factor may be prudent, but few studies have assessed the influence on mortality.
Table 78-3 Screening Recommendations for Asymptomatic Normal- Risk Subjectsa Test or USPSTF ACS CTFPHC Procedure 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 No examination recommendation recommendation recommendation Prostate- Insufficient M: ≥50, Recommendation
specific 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 considered examination 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 to examination recommendation monthly exclude Breast clinical Insufficient F: 20–40, F: 50–69, every examination 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 to examination evidence for or exam include or exclude against a Summary of the screening procedures recommended for the general population by U.S. Preventive Services Task Force (USPSTF), the American Cancer Society (ACS), and the Canadian Task Force on Prevention Health Care (CTFPHC). These recommendations refer to asymptomatic persons who have no
risk factors, other than age or gender, for the targeted condition. Note: F, female; M, male.