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The American Cancer Society’s (ACS) annual guidelines for the early detection of cancer have been updated and are published in the January/February issue of CA: Cancer Journal Clinic. These guidelines summarize recommendations for early cancer detection, emerging issues for cancer screening, and data on cancer screening rates for adults in the United States. No new updates were published in 2005.
The American Cancer Society provides testing guidelines for several specific cancers, including breast cancer, colon and rectal cancer, cervical cancer, endometrial (uterine) cancer and prostate cancer.
ACS guidelines for breast cancer screening recommend that average-risk women begin clinical breast examinations (CBE) beginning at age 20 and regular mammography beginning at age 40. Breast self-examination (BSE) is no longer recommended, but women are cautioned about the benefits, limitations and harms associated with BSE. More frequent exams should be conducted for women at increased risk.
ACS recommends both men and women at average risk should begin screening for colorectal cancer, following one the following tests:* yearly fecal occult blood test (FOBT) or fecal immunochemical test (FIT)* flexible sigmoidoscopy every 5 years* yearly FOBT or FIT plus flexible sigmoidoscopy every 5 years* double-contrast barium enema every 5 years* colonoscopy every 10 yearsAny positive test should be followed up with a colonoscopy. People with risk factors should begin screening earlier and more frequently.
ACS recommends cervical cancer screening beginning for all women about 3 years after vaginal intercourse, but no later than age 21. Annual screening should be done with a Pap test. At age 30, women with 3 normal Pap tests may be screened every 2 to 3 years, unless they have certain risk factors. Another option for women over 30 is a Pap test, plus the HPV DNA test.
ACS recommends informing women about the risks and symptoms of endometrial (cervical) cancer. Women with any unexplained bleeding or spotting should notify their doctors. High risk women should begin endometrial biopsy at age 35.
All men should be informed about the early detection risks and benefits for prostate cancer detection and screening. ACS recommends that the prostate-specific antigen (PSA) blood test and digital rectal exam (DRE) be offered annually to men age 50 or older, if they have at least a 10-year life expectancy. High risk men (African-American men or those with strong family of first degree relatives diagnosed at early age) should begin testing at age 45. Higher risk men (those with multiple first-degree relatives affected young) should begin testing at age 40.
