Cancer screening refers to a series of investigations needed to detect cancer early before symptoms begin. There are specific screening tests used for detection of specific types of cancer.

The benefit of cancer screening and early detection of cancer is so that successful treatment and complete remission of the cancer can be achieved.

What are the cancer screening guidelines?

The following are the guidelines for screening of specific cancer types as recommended by the American Cancer Society.

Breast Cancer

• Women between the ages of 40 to 44 may commence cancer screening with mammography yearly if they so choose.
• Women between the ages of 44 and 54 should get mammograms every year.
• Women above the age of 54 should get mammograms done every two years, however, they could continue getting mammograms done every year if they so wish.
• Breast cancer screening should continue as appropriate in all healthy women who are expected to live at least 10 years longer.
• All women should be aware of the pros and cons of breast cancer screening.
• Women who have a family history of breast cancer or a genetic predisposition to breast cancer should be screened with MRI scans in addition to mammograms.

Colon and Rectal Cancer and polyps

One of the following screening tests is recommended for men and women aged 50 years and above.

Tests that detect both cancer and polyps

• Colonoscopy every 10 years, or
• Double-contrast barium enema every 5 years, or
• CT colonography every 5 years, or
• Flexible colonoscopy every 5 years

Tests that detect mostly cancer

• Faecal immunochemical test (FIT) yearly, or
• Stool DNA test (sDNA) every 3 years, or
• guaiac-based faecal occult blood test (gFOBT) every year

If any of these tests which do not involve colonoscopy comes back positive, a colonoscopy should be done.

The tests which detect both polyps and cancer should be the one you choose from if you want to commence screening.

If you have a positive family history of colon cancer or you have a genetic predisposition, scheduling of your screening tests might be different.

Cervical Cancer

• Cervical cancer screening should begin at the age of 21 and not earlier.
• Women between the ages of 21 and 29 should be tested with Pap smear every 3 years. HPV testing should not be done unless Pap test comes back abnormal
• Women between the ages of 30 and 65 should have both Pap smear and HPV test done every 5 years.
• Women aged above 65 who have had regular uneventful cervical cancer screening should not have any more cervical cancer screening tests. However, for those in whom cervical pre-cancer was detected, testing should continue for at least 20 years after the detection.

Women with a history of HIV or organ transplantation may require different scheduling for their cervical cancer screening tests.

Lung Cancer

Screening for lung cancer involves a low-dose CT scan of the chest done yearly. It is recommended only for those at high risk of it. You are fit for lung cancer screening if you are:

• Aged between 55 and 74
• Have a 30-pack year smoking history and are still smoking or have quit smoking within the last 15 years.

Prostate Cancer

Prostate cancer screening is done with scheduled PSA blood tests, the frequency of which depends on the PSA level. Screening begins at the age of 50, but if your father or brother had prostate cancer before the age of 65, start screening from the age of 45.