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your Health your Decisions Volume 9, Issue 2 | February 2016 Screening for Cancer Breast and Colorectal Cancer Screening The American Cancer Society (ACS) estimates there will be nearly 1.7 million new cancer diagnoses, and nearly 600,000 cancer deaths, in 2016. While there are several risk factors for cancer you can’t control (gender, race, age, family history), there are lifestyle actions that have been associated with the prevention of cancer. Experts recommend living a healthy lifestyle, including not smoking, eating a well-balanced diet (more vegetables, fruits and whole grains/less processed food and red meat), protecting against sunburn, exercising regularly, keeping a healthy work/family balance, and having preventive screening tests that are right for you. Identifying cancer at its earlier stages increases the possibility of successful treatment. The Number One Cancer The most common kind of cancer is breast cancer. The National Cancer Institute estimates 246,660 women and 2,600 men will develop breast cancer, and 40,450 women and 440 men will die from the disease this year. Being a woman is the main factor associated with breast cancer risk, but also being 50 or older and having changes in breast cancer genes (BRCA1 and BRCA2). Factors that decrease risk include being older when menstruation started, entering menopause at a younger age (shorter exposure to the hormones estrogen and progesterone that can contribute to breast cancer), giving birth to multiple children when under 30 and breastfeeding, exercising regularly and being in a healthy weight range. These factors increase your risk: long-term use of hormone replacement therapy (including birth control pills), family history, exposure to DES (diethylstilbestrol) either personally or if taken by your mother during her pregnancy with you, dense breasts, use (or overuse) of alcohol and night-shift work. Since it is possible for women without any known risk factors (besides being female) to develop breast cancer, it is important to discuss your personal risk profile with your healthcare provider who may suggest preventive screenings. The ACS updated its screening recommendations last October and recommends that women of average risk start routine, annual mammography at age 45 and transition to screening every 2 years at age 55. The American College of Obstetricians and Gynecologists (ACOG) 415 W 17th Street, Suite 250 | Cheyenne, WY 82001 | www.hcmsgroup.com/knovasolutions T 800/355-0885 | F 307/316-0753 Screening for Colorectal Cancer and Polyps Sigmoidoscopy: a sigmoidoscope (flexible lighted tube with a camera on the end) is inserted in rectum/part of colon. Colon/rectum must be emptied with enemas/ laxatives. May include sedation and removal of polyps if present. Bleeding and puncture of the colon are possible, but very small risks. 5 years.* Colonoscopy: a colonoscope (thin lighted tube with a camera on the end) is inserted in rectum/colon. Requires test prep to empty colon/rectum. Usually includes sedation. Polyps or other tissue can be removed/sampled. Bleeding and puncture of the colon/ rectum are possible, small risks. 10 years.* Double-contrast barium enema: a chalky liquid (barium sulfate) and air are put in colon/rectum and x-rayed. Laxatives and enema are required to empty the colon/ rectum. No sedation. Very small risk of colon puncture. Exposure to a small amount of radiation. 5 years.* CT colonography: a CT (computed tomography) scan uses x-rays to view images of the colon/rectum, which must be emptied. Contrast solution taken orally. Air is pumped into colon/rectum. Very small risk of colon puncture. Exposure to a small amount of radiation. 5 years.* *General time frames, may vary. encourages women to perform selfexams (as part of general breast self-awareness) and to have clinical breast exams. ACOG states that women 40 years and older should be offered annual screening mammograms. The U.S. Preventive Services Task Force (USPSTF) recommends beginning mammograms at age 50 and performing them every 2 years until age 74. The risks of mammography include false-positive and false-negative results. False-positive results occur when a mammogram identifies abnormal tissue, but there is no cancer present. This situation requires additional testing, such as ultrasound and biopsy. A false-negative result reports no cancer when cancer is present; a mammogram is effective 80% of the time. The most likely reason for a false-negative result is dense breast tissue (more areas of fibrous and glandular tissue that make spotting cancer difficult). The risks and benefits of mammography can be discussed with your healthcare provider in light of your risk factors and values. Another Common Cancer While breast cancer leads the pack, colon and rectal (colorectal) cancers are also common. The ACS estimates 134,490 new cases will be diagnosed and 49,190 deaths associated with the disease will occur this year. The risk factors for colorectal cancer are family history of colorectal cancer, polyps and related genetic syndromes; and personal history of chronic inflammatory bowel disease (ulcerative colitis or Crohn’s disease). Colorectal cancer almost always develops from polyps (abnormal growths) in the colon or rectum. Screening tests are used to detect this cancer when no symptoms (abdominal pain, changes in bowel habits, bleeding, constipation or diarrhea) are present. Several organizations, including the ACS and USPSTF, have issued guidelines for colorectal screening and all agree that people without symptoms should begin routine screening at age 50. Each organization offers different guidelines for the frequency of screening and the age at which to stop screening. Colorectal cancer screenings that test for cancer and polyps are preferred, since polyps may develop before cancer. These tests are sigmoidoscopy, colonoscopy, doublecontrast barium enema, and CT colonography. If polyps or cancer are discovered during a sigmoidoscopy, barium enema or CT colonography, a colonoscopy will be recommended. These tests are described in the box on the left. Screening tests for cancer only (not polyps) are stool sample tests that look for blood in the stool. They include the fecal occult blood test, the fecal immunochemical test, and the stool DNA test. If blood is found, additional testing is required. Your Health, Your Decision Deciding to have preventive screening tests for cancer is a personal decision. It is helpful to consider your family history, current health, personal preferences and your provider’s recommendations. KnovaSolutions is available to provide more information about the risks and benefits of available screening options for these and other types of cancer. Call 800/355-0885. The information contained in this newsletter is for general, educational purposes. It should not be considered a replacement for consultation with your healthcare provider. If you have concerns about your health, please contact your healthcare provider. © 2015 HCMS Group | [email protected] | All information is confidential and HIPAA protected.