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Which Cancer Tests Do You Really Need?

Cancer Screening: CR Ratings continued...

The other eight tests were not recommended for those not at high risk because the cancers are uncommon, the test's effectiveness is not proven, or the test can't detect the disease at a curable stage. And even though some of the tests aren't really recommended by anyone, this list is a valuable reminder for people who may feel they need to seek them out.

On the "avoid" list, screenings for:

  • Bladder cancer. The test looks for blood or cancer cells in the urine.
  • Lung cancer. The test is a low-dose CT scan. The ACS only recommends this for high-risk people (such as older individuals who've smoked for years).
  • Skin cancer. The test is a visual exam of your skin to spot signs of the deadly skin cancer melanoma. The ACS says a skin exam by a doctor should be included as part of the routine check-up.
  • Oral cancer. This visual exam of the mouth is done by a dentist or other health care professional. The ACS suggests this as part of your normal routine oral care.
  • Prostate cancer. The blood test is known as the PSA (prostate-specific antigen) test. The ACS says to discuss PSA tests with your doctor, but doesn’t recommend widespread screening of everyone.
  • Ovarian cancer. Tests include a blood test to look for a protein linked with the cancer, and a transvaginal ultrasound. This test is generally not recommended by anyone for the general public.
  • Pancreatic cancer. Tests are abdominal images or genetic tests. This test is also generally not recommended by anyone for the general public.
  • Testicular cancer. The test is a physical exam of the testicles. ACS does recommend this as part of routine care; the task force doesn't.

Cancer Tests: Perspectives

The new ratings drew mixed reactions.

Otis Brawley, MD, chief medical officer of the American Cancer Society, says the report helps to put screening into its proper perspective. "There has been a significant amount of over-promising and over-promoting," he says.

He frowns on aggressive campaigns that have included mammogram parties or group colonoscopies.

"A lot of screening is being done by organizations that can profit from it," he says.

"The truth is, certain tests do have some significant benefit, and every test has some limitations," he says. "In the spirit of informed decision-making, people need to understand both the potential for benefit and the potential for harm."

As mentioned, the recommendations on breast cancer screening from Consumer Reports and the American Cancer Society are different, but Brawley calls these differences ''minimal."

"We recommend women in their 40s get a mammogram on an annual basis, but we also recommend those women get information on the limitations," he says.

These include missing some cancers and ordering additional tests when no cancer turns out to be there.

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