As you write up your health to-do list this year, find out from your doctor which cancer screenings you should have. These tests can help catch the disease early, and in some cases, treat it at the same time.
Breast Cancer
A test can often find this type of cancer when a lump is too small for you to feel, and before the disease has spread to other parts of your body.
Mammogram. This is the main way doctors check for breast cancer. It uses X-rays to create pictures of the inside of your breasts.
A 3D mammogram takes several pictures so your doctor can see your breast from different points of view.
A technician will place one breast at a time on a special platform. Then a clear plastic paddle will press on your breast to spread it out. This is done to make sure the X-ray gets all your tissue in the picture. You may need to change positions so the technician can take pictures from different views. You'll have to hold your breath for a couple of seconds.
Sometimes, mammograms can find something abnormal that requires a biopsy to tell if it is cancer or not. The likelihood that an abnormality will turn out to be cancer depends on your age and your other risk factors for breast cancer. This is why women of different ages have different different recommendations.
- The U.S. Preventive Services Task Force (USPSTF) says women ages 50 to 74 should have mammograms every other year. Women in their 40s may choose to get one every other year.
- The American Cancer Society says women ages 45 to 54 should have it done once a year, although you could start as early as 40 if you want to. Those 55 or older should get them every 1-2 years.
If you're more likely to get breast cancer because of a family history or other reasons, check with your doctor. You might need to have mammograms earlier and more often than these guidelines recommend. You may also need to add other screening tests, such as an MRI.
Breast self-exams. Most health groups don't recommend that women do these anymore. If it's something you'd like to do to be familiar with your breasts, talk to your doctor about what you should look and feel for. If you or a partner notice a new lump or nodule in your breast or under your arm, you should see your doctor. Trust yourself.
Lung Cancer
It's the deadliest cancer in women, and it's no secret that smoking is the major cause. If you're a regular tobacco user, you may want to talk to your doctor about coming up with a plan to quit. There are medications that are effective and safe to help you quit. You usually take them for 3-6 months. There is also nicotine replacement.
Doctors check for lung cancer with a low-dose computed tomography (LDCT) scan. It uses X-rays to make pictures of your lungs.
It's an easy procedure. You lie on your back and raise your arms over your head as the table moves through the scanner. You hold your breath for 5 to 10 seconds while it's done.
You should probably get an LDCT scan once a year if you:
- Are ages 50 to 80
- Have a 20 pack-year smoking history (calculated by multiplying the number of packs of cigarettes smoked per day by the number of years you smoked; if you smoked 2 packs daily for 10 years, you have 20 pack years of smoking)
- Smoke now, or you quit within the past 15 years
Your doctor will let you know if and when it's OK to stop getting annual scans.
Colorectal Cancer
It's the third most common cancer in women. Since the disease usually starts with growths called polyps in your colon, a part of your digestive system, some screening tests look for them. The goal is to find them before they can turn into cancer or while they're still in the early stages.
Colonoscopy. Your doctor will check your entire colon and rectum with a flexible tube that has a camera on the end. You'll need to do some prep work. A day or so before it's done, you'll only be allowed to drink liquids, and you'll take a laxative to clean out your colon.
The procedure, which takes about 30 minutes, shouldn't hurt. You'll get numbing medication as well as medicine to make you drowsy or put you to sleep. Your doctor will usually remove any polyps and perhaps bits of tissue from your colon. Then they'll send them to a lab to get checked for signs of cancer.
Flexible sigmoidoscopy. It's a lot like a colonoscopy, but not quite as thorough. Your doctor can only check about a third of your colon. On the positive side, you don't have to do as much prep, and you can usually stay awake. This test takes about 20 minutes.
Fecal tests. Both the guaiac-based fecal occult blood test (gFOBT) and the fecal immunochemical test (FIT) look for tiny amounts of blood in your poop because cancers in the colon and rectum sometimes bleed.
You use a special kit that lets you collect a small amount of your poop at home. You send the kit to a lab, where technicians check the samples. You may have to avoid certain foods and medicines beforehand.
A stool DNA test is similar, but the lab will also check for traces of cells from polyps or cancer with changes in their genes.
You should get your first colorectal cancer screening test when you're 45 years old. You may need to do it earlier if you're more likely to get colorectal cancer. If you're older, ask your doctor whether you need to.
How often you should get tested after that depends on which type of screening you get and whether an earlier screen revealed polyps. The USPSTF recommends:
- Colonoscopy once every 10 years (or 5 years if polyps were discovered in an earlier screen), or
- Flexible sigmoidoscopy every 10 years, plus FIT every year (but the American College of Physicians says flexible sigmoidoscopy every 5 years, plus FOBT or FIT every 3 years), or
- FOBT every year
Cervical Cancer
It starts in cells that line the cervix, the lower part of your uterus. With one of these tests, your doctor can often spot these slowly changing cells before they cause trouble.
Pap test. You lie on a table with your feet in leg rests. Your doctor puts a tool called a speculum into your vagina to widen it enough to see your cervix.
Then they'll use a special scraper or brush to remove a sample of cells. You might feel a little discomfort. The cells go to a lab, which tests them for cancer.
Human papillomavirus (HPV) test. It can be done along with the Pap test, using the same collected cells. The lab checks to see if you're infected with HPV, a virus that causes most cases of cervical cancer.
Generally, beginning at age 21, women should get a Pap test every 3 years. Beginning at age 30, some may have the option to get both a Pap and HPV test every 5 years. Your doctor will recommend the best strategy for you, based on things like your age, test history, and likelihood of getting cancer.
Skin Cancer
The USPSTF doesn't recommend for or against skin exams, but the American Cancer Society says regular checks by your doctor are a good way to find skin cancers early. If you've had the disease in the past or you have family members who've had it, ask your doctor how often you should get a skin exam.
Your doctor will look for any moles or other growths on your skin that might be cancer. You can also check your skin for changes yourself at least once a month.
