Did you skip your cancer screenings last year? It’s time to reboot


Many people postponed routine medical care due to disruptions related to the Covid-19 pandemic. This includes a decrease in cancer screenings, such as mammograms and colonoscopies. Meanwhile, cancer remains a leading cause of death in the United States, second only to heart disease.

Why is cancer screening so important and who should be screened for which types of cancer? How can you find out when your last exam was and what you need to do now? What if someone has fallen behind on their cancer tests? And what should people do if they are still very concerned about their risk of contracting the coronavirus?

To help us with these questions, I spoke with CNN medical analyst Dr. Leana Wen, an emergency physician and professor of health policy and management at George University’s Milken Institute School of Public Health. Washington. She is also the author of “Lifelines: A Doctor’s Journey in the Fight for Public Health.”

CNN: Why is it so important to get a cancer check?

Dr. AS Leana Wen: Regular cancer screening is key to detecting cancer early. This allows cancers to be found before someone has symptoms. In general, early detection of cancer gives better results. A small, localized tumor can be removed before it has spread to other parts of the body, for example. Screening can also find abnormal cells that could turn into cancer, and prompt treatment could prevent that cancer from developing and spreading.

CNN: Who should be screened for which cancers and when?

Wen: The three main types of cancer screening supported by the US Centers for Disease Control and Prevention are for breast, cervical and colorectal cancer. The US Preventive Services Task Force (USPSTF), an influential national organization that makes disease prevention recommendations, recommends mammograms every two years for women ages 50 to 74 who have an average risk of breast cancer. mom

A mammogram is a type of X-ray and is available at most hospitals and outpatient radiology centers. According to the USPSTF, people at highest risk within this age group and those under 50 should talk to their doctor about how often they should be tested. Some other medical organizations, including the American Cancer Society, recommend more frequent annual screening mammograms.

Cervical cancer screening is done using a Pap test, in which a doctor performs a gynecological exam to collect some cells and mucus from the patient’s cervix. The USPSTF recommends that women and others who have a cervix get a Pap test every three years from age 21 until age 65. Some people may receive more frequent screenings, depending on their risk factors.

The USPSTF also recommends that all adults between the ages of 45 and 75 be screened for colorectal cancer. There are several screening tools involved. One is a stool-based test that detects the presence of certain markers in the stool. Another is colonoscopy, which involves a procedure that uses a long, flexible scope to look at the rectum and colon. A colonoscopy is generally recommended every 10 years. Which tests, and how often, will also depend on the individual’s medical and family history.

CNN: What about lung cancer, which is another leading cause of death?

Wen: The CDC also supports lung cancer screening, specifically for people ages 50 to 80 who have a history of heavy smoking, who smoke now, or who have quit smoking within the past 15 years. The USPSTF recommends an annual low-dose computed tomography scan, which is a type of CT scan that can be done in many hospitals and radiology facilities.

CNN: Are there other cancers that people should be calling for, for example, what about ovarian cancer or pancreatic cancer?

Wen: There are many cancers, including ovarian, pancreatic, thyroid, and skin cancers, for which there is insufficient evidence to justify regular and ongoing screening in individuals with average risk factors. If a particular type of cancer runs in your family, you should ask your doctor about the benefits of screening. Of course, if you develop symptoms, for example, you discover a new growth on your neck or there is discoloration of the skin that changes its appearance, you should definitely see your health care provider.

CNN: Many people may not remember when they last had a screening test, especially if they moved or changed health care providers. How should they find out if they have to pay?

Wen: If you’ve had the same doctor all along, you can call your doctor’s office and find out the dates of your last screening tests. If you’ve changed doctors but are in the same hospital network, your health system should have these records, and you may be able to access them if your provider offers an electronic patient portal.

Another possibility is to contact your insurance company, if you have had the same insurance company for the past few years. They should also have records of recent preventive tests. And you can always contact previous suppliers. It’s generally a good idea to have copies of your old medical records so they can be compared to new test results.

CNN: What if you miss several screening tests? Would you recommend that people update them as soon as possible?

Wen: Yes. Many patients missed screening tests for all kinds of reasons. Perhaps the fear of Covid-19 caused delays. Maybe they moved or changed jobs. Maybe they had children or grandchildren or other new caregiving responsibilities, and life got busy. Find out which tests you need to take and start scheduling them now.

I would add that this also applies to other preventive services. Make sure you’re also on track with screening for high blood pressure, diabetes, high cholesterol, and other chronic conditions. The sooner these conditions are caught and flagged as potential problems, the sooner you can learn about them and start solving them.

CNN: There are some people who remain very concerned about their risk of contracting Covid-19 while being tested. What is your advice to them?

Wen: Healthcare environments tend to be very cautious and have been taking many measures to reduce the risk of Covid-19. People who are concerned about contracting Covid-19 should ask the facility where they will be testing what kind of mitigation measures are being used. Are all staff masked while seeing patients, for example? Remember that one-way masking with a high-quality mask works very well. For mammograms and Pap tests, and for visits with your doctor, you may wear an N95 or equivalent throughout the exam. For colonoscopies, this might not be possible throughout the procedure, but the colonoscopy will almost certainly be done in a room where others are masked the entire time.

You can also further reduce your risk of serious illness by making sure you’re up to date with your coronavirus boosters. If you are eligible for the preventive antibody Evusheld, you should also take advantage of this.

Finally, it is important to put the risk of Covid-19 in context. The absence of the coronavirus is not the only indicator of good health, and we must consider good health, both physical and mental, in a holistic way, which includes staying on top of preventive health care as cancer detections.

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