The Risks of Cancer Screening
With More Cancer Screening and Earlier Testing, Overtreatment on the Rise
To Screen or Not to Screen?
Some people are at higher risk of cancer than other people. For example, a woman may have inherited genes that raise her risk of breast cancer. Or she might be a smoker, raising her risk of lung cancer.
For people at risk of cancer, the benefits of screening often outweigh the harms. For those not at risk, deciding on whether to undergo cancer screening can be a close call.
The USPSTF recommends routine screening -- that is, for people at normal risk -- for only three cancers:
- Breast cancer screening mammography is recommended for all women aged 50 to 74. Women under age 50 must weigh the benefits and harms before deciding to undergo screening mammography.
- Colon cancer screening is recommended for all adults from age 50 until 75.
- Cervical cancer screening every three years via Pap smear is recommended for all women aged 21 to 65. At age 30, women may opt for screening every five years with a combination of Pap tests and testing for human papillomavirus (HPV).
Groups such as the American Cancer Society and the National Cancer Institute say CT screening should be offered to those at high risk of lung cancer. That includes smokers and former smokers ages 55 to 74 who have smoked for 30 pack-years or more and either continue to smoke or have quit within the past 15 years. A pack-year is the number of cigarette packs smoked each day multiplied by the number of years a person has smoked. Their guidelines are based on research that showed CT screening decreases the chance of death overall but increases the chance of having a false alarm that requires more testing.
The USPSTF says there's not enough evidence to recommend for or against routine screening for bladder, oral, and skin cancers. The panel advises against routine screening for ovarian, pancreatic, prostate, and testicular cancers.
If you're not sure what cancer screenings are recommended for you -- or you're not sure you want to go through with those tests -- talk it over with your doctor. Ask for the pros and cons of testing, in light of your preferences, overall health, and family history.