Best Practices In Breast, Cervical And Colorectal Cancer Screening Translated Into Risk-Based Guidelines For The Public
November 21, 2011
Healthcare Prof:
3.67 (3 votes)
Drawing on years of expertise in cancer investigation and patient care, The University of Texas M. D. Anderson Cancer Center have just released one of the most comprehensive, risk-based screening guidelines publicly available to date for breast, cervical and colorectal cancers.
The new recommendations represent the first wave of an effort by M. D. Anderson to improve the effectiveness of efforts to prevent and detect cancer at its earliest, most treatable stage by reconstructing and expanding its screening, danger reduction and diagnostic guidelines across eight disease sites.
Available on M. D. Anderson’s Web site, the recommendations translate best practices in cancer prevention employed at M. D. Anderson into accessible guidelines the public can follow, with threat categories identified and information about when to begin and discontinue screening exams.
According to the American Cancer Society, more than 40 percent of Americans will develop cancer throughout their lifetime, and cancers that can be prevented or detected earlier by screening account for at the very least half of all new cancer situations.
“Cancer screening is not one-size-fits-all,” stated Therese Bevers, M.D., medical director of M. D. Anderson’s Cancer Prevention Center. “Our new risk-based recommendations are markedly far more personalized and precise, offering detailed guidance than what has previously been produced available to the public here or by other cancer organizations.”
Until now, cancer screening recommendations were targeted largely to individuals at average risk for creating cancer according to characteristics like age, family history or genetic predisposition. However, average threat was not previously defined and recommendations for individuals at elevated or high risk were not outlined. The new screening guidelines define danger and offer recommendations for those at elevated and high danger of developing cancer. For example, there are now five different sets of screening recommendations for those at increased risk for breast cancer; four categories of age-based risk recommendations for cervical cancer; and for colorectal cancer, there are 3 categories defining those at increased threat and 3 categories defining those at high threat.
The new guidelines build on established cancer screening practices and now a lot more specifically offer the following recommendations:
Breast Cancer
Starting at age 20, females at all danger levels should practice breast self-awareness by getting familiar with how their breasts look and feel and immediately reporting any changes to their doctor. Females aged 40 years and older at average danger should get annual mammograms and breast exams.
For girls at increased danger, the type and frequency of exams – such as clinical breast exams, mammograms and breast MRI – depend on factors putting them at elevated danger, including: history of radiation remedy to the chest;
genetic predisposition;
diagnosis of lobular carcinoma in situ;
Gail Model score of greater than 1.7 percent;
or family history. Cervical Cancer
For women at average threat, it’s now recommended that females under age 21 get a liquid-based Pap test within 3 years of initiating vaginal intercourse. She should continue to have Pap tests annually until she has had three consecutive negative test results. Right after that, M. D. Anderson recommends screening every two years unless she is at increased risk of cervical cancer based on danger factors, such as: history of cervical cancer or severe cervical dysplasia;
persistently testing positive for Human Papilloma Virus (HPV);
exposure to diethylstilbestrol (DES) before birth;
Human Immunodeficiency Virus (HIV) infection;
or an immune method that does not function properly. Beginning at age 30, adding HPV testing can be a preferred option towards the Pap test, and if both are negative, a woman could go to each and every three years unless she is at increased risk according to the risk factors cited above or unless the optional HPV test was not done.
Colorectal Cancer
M. D. Anderson recommends a colonoscopy every single 10 years (preferred screening), a virtual colonoscopy every 5 years, or a yearly Fecal Occult Blood Test (FOBT) for men and women aged 50 years and older who are at average risk. For men and ladies at increased or high threat, the form and frequency of exams – such as colonoscopy and flexible sigmoidoscopy – depend on the following factors: personal history of precancerous (adenomatous) polyps;
personal history of colorectal cancer;
family history of colorectal cancer or precancerous (adenomatous) polyps;
genetic diagnosis of Familial Adenomatous Polyposis;
genetic history of Hereditary Nonpolyposis Colorectal Cancer or a clinical history suggesting such;
or inflammatory bowel disease (ulcerative colitis or Crohn’s disease). “Because of the investigation being conducted in laboratories and clinics at M. D. Anderson and around the world, our understanding of how cancer develops and spreads is steadily increasing,” stated Ernest T. Hawk, M.D., M.P.H., vice president for Cancer Prevention and Population Sciences.
More knowledge about how doctors make decisions about threat levels and screening tests will give patients a deeper understanding of the disease process and enable them to put their own cancer threat in perspective, he added.
“For colorectal cancer screenings, patients want to be proactive about obtaining results from their screening tests. For example, if a colonoscopy reveals polyps, it truly is crucial for the patient to know what kind, how many and what size, considering that this data factors heavily into what risk category they fall into for colorectal cancer,” Bevers said.
The risk categories and related guidelines were developed by multidisciplinary panels of M. D. Anderson disease site experts across a number of areas, including: medical oncology, surgical oncology, cancer prevention, imaging and others. Risk-based screening guidelines for prostate, liver, skin, endometrial and ovarian cancers are currently in development along with a new online threat assessment tool integrating the new screening guidelines will be launched on the M. D. Anderson Web site in early 2010.
Breast, Cervical and Colorectal Cancer Statistics
In 2009, the American Cancer Society estimated: New circumstances of breast cancer will be diagnosed in 192,370 females and 40,170 will die from breast cancer;
11,270 new cases of cervical cancer will be diagnosed in females and 4,070 ladies will die from cervical cancer;
New cases of colorectal cancer will be diagnosed in 106,100 men and women and 49,920 men and girls will die from colorectal cancer. Source:
Robyn Stein
University of Texas M. D. Anderson Cancer Center
Filed under: French Village