Screenings

Screenings are tests that look for diseases before you have symptoms.
Screening tests can find diseases early, when they’re easier to treat.

If you are uninsured or underinsured, you may quality for certain free health screenings through the
NJCEED Program at Virtua Health.

Early Detection

The goal of regular screenings is to detect disease early enough to treat it most effectively. The early
detection may lead to a better overall prognosis and longer survival.

Alcohol Use

According to the National Cancer Institute, there is a strong scientific consensus that alcohol drinking
can cause several types of cancer.

In its Report on Carcinogens, the National Toxicology Program of the US Department of Health and
Human Services lists consumption of alcoholic beverages as a known human carcinogen.

The evidence indicates that the more alcohol a person drinks—particularly the more alcohol a
person drinks regularly over time—the higher his or her risk of developing an alcohol-associated
cancer.

Learn more about the cancer risks associated with alcohol consumption

Alcohol & Cancer Risk Factors

Tobacco Use

Our collective efforts to reduce tobacco use, are multifaceted:

 Tobacco Free for a Healthy NJ (TFHNJ) is a statewide project focusing on increasing

residents’ access to smoke-free air where they work, live, and play.

 Outdoor Recreation Ordinances (ORO): Many municipalities in Burlington and Camden

counties have adopted OROs and are smoke-free.

 One of the ways to reduce youth access to cigarettes, ENDS (electronic nicotine delivery
systems), and hookah is by implementing point-of-sale (POS) strategies in establishments
that sell these products, particularly within municipalities where retailers are in close
proximity to schools.

 Tobacco Retailer Audits are conducted to assure compliance with state guidelines.

Nutrition

A healthy diet helps to prevent a variety of diseases and can assist with the management of many
chronic conditions.

The U. S. Department of Agriculture (USDA) has a wealth of resources on their website

at Nutrition.gov.

Additionally, proper nutrition can help those undergoing treatment programs and navigating life
after disease. You can also find nutrition resources for people with cancer and cancer survivors, on
topics including eating, food safety, and dietary supplements on the USDA website:
Physical Activity

Physical activity is anything that gets your body moving!

Movement has many benefits, including reducing obesity, which is a known risk factor for a variety
of cancers. If you are wondering how much physical activity is right for you, and need some ideas on
activities to try and how to fit them in, you can learn more:

Cancer is a leading cause of death worldwide, second only to heart disease in the United
States. Cancer screening is essential for early detection and prevention. According to the
Centers for Disease Control and Prevention (CDC), there were 606,520 cancer deaths, and
new cancer cases in 2020 were expected to exceed 1.8 million. Globally, nearly 20 million
new cancer cases and almost 10 million deaths are reported annually. Fortunately, early
screening for cancers such as colon, lung, cervical, breast, and prostate can delay or halt
disease progression, increase cure rates, and reduce morbidity and mortality.[1]
Cancer screening is a form of secondary prevention that reduces mortality without altering
disease incidence. Given the lengthy process of malignant transformation, screening allows
for the detection of premalignant lesions and early intervention, slowing disease progression
and enabling early curative treatment when appropriate.[2] Most cancer risk factors are
preventable. Measures such as eliminating tobacco products and secondhand smoke
exposure, getting vaccinated (eg, against human papillomavirus or HPV), avoiding tanning
beds, maintaining a healthy weight, staying physically active, abstaining from processed or
red meat, and consuming high amounts of fruits and vegetables can substantially decrease a
person's lifetime risk of developing cancer or dying from the condition.[3]
Healthy People Initiative (HPI) is a US program that develops health objectives and tracks
the achievement of these objectives. The National Health Interview Survey (NHIS) is a
chosen data source for setting and assessing several HPI cancer targets.[4] The 2015 NHIS
findings showed that the utilization of cancer screening tests for cervical, breast, and
colorectal cancer (CRC) was below the Healthy People 2020 targets. In 2015, the rates of Pap
tests, mammography, and CRC screening were 80%, 70%, and just above 60%, respectively.
In contrast, the Healthy People 2020 targets are 93% for Pap tests, 81% for mammography,
and 70.5 % for CRC screening.[5] This activity reviews the 4 most common cancers and their
respective screening guidelines as recommended in the United States.
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Function
Breast Cancer
Breast cancer is the most common cancer among women and the second most common cause
of cancer death in the United States. Female breast cancer incidence was on a declining trend
before 2004 but has since increased at an average of 0.4% per year. After an initial
incidence reduction in the early 2000s following the cessation of hormone replacement
therapy, the period from 2004 to 2014 showed an increase in incidence, which may partially
be attributed to the obesity epidemic.
As mammography rates remained constant during this period, the recent rise in breast cancer
incidence cannot be attributed to increased detection through mammography. However, due
to breast cancer screening, most cases are diagnosed at stage I, which has a 5-year survival
rate of 100%.[6] From 1989 to 2015, breast cancer mortality dropped by 39%. The mortality
rate among women aged 50 and older has continued to decline since 2007, while it has
remained steady for women aged 50 or younger.[7] Widely accepted breast cancer screening
modalities include mammography, breast magnetic resonance imaging (MRI), digital breast
tomosynthesis (DBT), breast ultrasound, and breast self-examinations.
According to the United States Preventive Services Task Force (USPSTF) guidelines, women
aged 50 to 74 are recommended to undergo biennial mammography. For women aged 40 to
49, the decision to screen should be individualized, as the reduction in breast cancer deaths is
smaller compared to the rate of false-positive results and unnecessary biopsies.[8] Frequent
screening also increases the risk of overdiagnosis and overtreatment. This contrasts with the
American Cancer Society (ACS) guidelines, which strongly recommend annual
mammography beginning at age 45, and a discussion of the pros and cons with women aged
40 to 44.
The ACS also recommends transitioning to biennial screening or continuing annual screening
in women aged 55 or older. Women should not discontinue screening mammography after
age 75 if their general health is good and their life expectancy is 10 years or longer.
According to the USPSTF guidelines, evidence is insufficient regarding the benefits and risks
of mammograms in women aged 75 or older. The same applies to women with negative
mammograms due to dense breasts, as well as the use of DBT, breast ultrasound, breast MRI,
and other modalities.
According to ACS guidelines published in 2007, annual mammography with MRI is
recommended for women at increased risk of breast cancer. This group includes women with
a known BRCA mutation, as well as those with a first-degree relative with a BRCA mutation.
Additionally, women with a 20% to 25% or higher lifetime risk of breast cancer, as predicted
by breast cancer risk-estimation models, are included. Screening protocols would include
pedigree analysis of first- and second-degree relatives on both paternal and maternal sides,
individuals treated for Hodgkin disease with chest irradiation before age 30, women with
Cowden, Li-Fraumeni, and Bannayan-Riley-Ruvalcaba syndromes, and the first-degree
relatives of all these patients. The ACS guideline for women at increased risk is currently
being updated.
Cervical Cancer
Cervical cancer is the second leading cause of cancer death among women aged 20 to 39.
[9] Cervical cancer was diagnosed in 569,847 women globally and had a mortality of 311,365
in 2018.[10] In the United States, the ACS projects 13,820 new cases of invasive cervical
cancer and 4360 deaths from the disease in 2024. According to the World Health
Organization (WHO), approximately 660,000 new cases of cervical cancer are expected
globally in 2022, with approximately 350,000 deaths.
Persistent HPV infection is the primary cause of cervical cancer. According to NHIS 2013
data, approximately 80% of women aged 21 to 65 received Pap tests in the last 3 years. The
HPV vaccine protects against 9 types of HPV, preventing about 90% of cervical, anal, vulvar,
and vaginal cancers. However, vaccination rates among adolescent girls and boys remain
low, at 37.6% and 13.9%, respectively. Cervical cancer screening tests include the Pap test,
the Pap test with HPV co-testing, and high-risk HPV (hrHPV) testing alone.
As per USPSTF guidelines, women aged 21 to 29 should undergo cervical cytology every 3
years. For women aged 30 to 65, screening options include cervical cytology alone every 3
years, hrHPV co-testing every 5 years, or hrHPV testing alone every 5 years. The USPSTF
advises against cervical cancer screening in women aged 21 or younger, those who have had
a hysterectomy with cervix removal and no history of high-grade precancerous lesions or
cervical cancer (ie, cervical intraepithelial neoplasia or CIN of grade 2 or 3), and women
aged 65 and older with adequate prior screening and not at high risk for cervical cancer.[11]
The screening recommendations, as per the joint guidelines of the ACS, American Society of
Clinical Pathology (ASCP), and American Society of Colposcopy and Clinical Pathology
(ASCCP), align closely with those of the USPSTF, advocating against screening before age
21. For women with atypical squamous cells of undetermined significance (ASC-US) and a
negative HPV test result, the guideline suggests repeating the screening test in 3 years. HPV
vaccination status does not influence cervical cancer screening practice. Screening can be
discontinued after age 65 if women have had 3 consecutive negative cytology tests or 2
consecutive negative co-test results in the last 10 years before discontinuing screening, with
the latest test performed within the past 5 years. Women with ASC-US and HPV-negative
results should be considered for screening discontinuation. Once screening is ceased, it
should not be restarted for any reason, even in women with new sexual partners. Following
the spontaneous resolution or appropriate management of CIN 2, CIN 3, and adenocarcinoma
in situ, routine screening should continue for at least 20 years, even if this extends beyond
age 65.
Lung Cancer
Lung cancer is the number one leading cause of cancer death. The ACS estimates new lung
cancer cases and deaths in the US in 2024 to be 234,590 and 125,070, respectively. The
National Lung Screening Trial (NLST), conducted in 2011, is one of the largest multicenter
randomized lung cancer screening studies worldwide. NLST assessed the reliability of low-
dose lung computed tomography (LDCT) in lung cancer screening. Mortality from lung
cancer was the primary endpoint. The study concluded that LDCT screening reduced lung
cancer mortality by 20%. The NLST findings formed the basis of the USPSTF
recommendation for lung cancer screening. However, concerns persist due to the NLST's
limited representation of the Black American population, accounting for only 4%, and its
failure to address differences in smoking behaviors among racial groups.[12]
According to USPSTF guidelines, adults aged 55 to 80 who are currently smoking or have a
30-pack-year history of smoking and have quit within the last 15 years should undergo annual
LDCT screening. Screening should be discontinued once the individual has not smoked for
15 years, has a limited life expectancy, or is unable to undergo curative lung surgery due to
health problems.[13] The ACS recommendation is similar to that of the USPSTF but applies
to individuals aged 55 to 74. As with the USPSTF recommendation, current smokers should
receive evidence-based smoking cessation counseling. Patients should also participate in an
informed, shared decision-making process regarding the benefits, harms, and limitations of
LDCT screening and have access to a high-quality lung cancer screening and treatment
center. Past studies have shown that fully implementing screening in the target population, as
described in the NLST trial, could prevent 12,250 lung cancer deaths annually.[14]
Colorectal Cancer
CRC is the second most common cause of cancer-related death in the United States.
According to data from the National Institutes of Health, new CRC cases are estimated to
reach 147,950, with CRC-related deaths predicted to reach 53,200. CRC screening options
include an annual high-sensitivity fecal immunochemical test (FIT), an annual guaiac-based
fecal occult blood test (g-FOBT), a multitarget stool DNA test every 3 years, colonoscopy
every 10 years, flexible sigmoidoscopy every 5 years, and computed tomography (CT)
colonography every 5 years.
The ACS CRC screening guidelines were updated in 2018. Over the past 2 decades, CRC
incidence and mortality have decreased, primarily due to effective screening practices. Adults
aged 45 and older with an average risk of CRC should undergo screening using either a high-
sensitivity stool-based test or a structural (visual) examination based on patient preference
and test availability. Positive results from non-colonoscopy screening tests should be
promptly followed up with a colonoscopy as part of the screening process. The ACS strongly
recommends that adults aged 50 and older begin screening with the methods mentioned
above. Adults with average risk and good health with a life expectancy of more than 10 years
can continue screening for CRC until age 75. CRC screening decisions should be
individualized for adults aged 76 to 85 based on patient preferences, health status, life
expectancy, and prior screening history. Individuals aged 85 and older may discontinue CRC
screening.
High-risk patients include people with a family history of CRC or an advanced adenoma in a
first-degree relative before age 60 or 2 first-degree relatives at any age. These patients should
undergo colonoscopy every 5 years, starting 10 years before the youngest relative's diagnosis
or at age 40, whichever is earlier. Individuals with a single first-degree relative diagnosed
with CRC at age 60 or older or with an advanced adenoma may consider average-risk
screening options starting at age 40.[15] Colonoscopy is the gold standard screening tool for
CRC.[16] This modality allows for the detection and resection of precancerous and cancerous
lesions. Adverse event rates are low, with colonic perforation occurring in 0.010% to 0.067%
of screening/surveillance colonoscopies and 0.022% to 0.268% of diagnostic colonoscopies.
[17]
Stool-Based Tests
g-FOBT detects blood in stool based on the peroxidase activity of heme. The test is
noninvasive, inexpensive, and has the highest quality of evidence from randomized
controlled trials. However, because the test relies on simple oxidation, dietary peroxidases
(eg, from plants), heme from red meat, or antioxidants (eg, vitamin C) can confound results.
The g-FOBT has a low positive predictive value (PPV) of 3% to 10% but a good negative
predictive value of 94%.[18]
FIT uses human globin antibodies, minimizing the likelihood of cross-reaction with dietary
meat. FIT specifically detects colonic blood, unaffected by upper gastrointestinal globin,
which may be contaminated by digestive proteolytic enzymes. A recent systematic review
and meta-analysis demonstrated FIT's high accuracy in detecting CRC, with an overall
accuracy of 95%, sensitivity of 79%, and specificity of 94%.
Stool deoxyribonucleic acid (DNA) testing uses Cologuard—the first multitarget stool DNA
test approved by the US Food and Drug Administration (FDA) in August 2014 for CRC
screening. Cologuard detects abnormal DNA present in stool samples from individuals with
malignancies. Comparative studies between FIT and stool DNA testing indicate higher
sensitivity but lower specificity and increased false-positive rates for the latter.[19] As per
USPSTF guidelines, screening should commence at age 50, utilizing stool-based tests
(gFOBT, FIT, and FIT-DNA) or direct visualization tests (colonoscopy every 10 years,
sigmoidoscopy every 5 years, or CT colonography every 5 years, if combined with annual
FIT).
The Septin9 (SEPT9) DNA serology test recently gained FDA approval for CRC screening.
However, a systematic review found its sensitivity for detecting CRC to be less than
50%. This test does not feature among the recommended screening tests for colon cancer.
[20] For patients aged 75 or older, the USPSTF guidelines agree with the ACS
recommendations, which strongly discourage routine screening colonoscopies beyond age 85.
According to the USPSTF, no conclusive evidence from head-to-head trials supports one
screening method over another, with ongoing studies like the CONFIRM trial comparing
colonoscopy with FIT for reducing CRC mortality. USPSTF hasn't yet evaluated evidence on
screening high-risk populations.
SEPT9 is a PCR serology test that detects hypermethylated SEPT9 DNA in the tumor DNA
that has been shed into the bloodstream from all intestinal anatomical sites. The FDA
approved Epi proColon (also recognized as the methylated SEPT9 or mSEPT9 assay) for
CRC screening in April 2016, marking the first approval of its kind for blood-based CRC
screening. A prospective multicenter study comparing Sept9 testing with FIT showed similar
sensitivity (73% versus 68%) but substantially lower specificity (81% versus 97%). However,
studies have noted that offering a noninvasive test for CRC screening improved compliance
with testing. For instance, in a study, 97% of individuals who declined colonoscopy were
willing to do a noninvasive test, and 83% of the study participants were willing
to undergo the SEPT9 test.[21]
Prostate Cancer
Prostate cancer ranks as the second leading cause of cancer-related deaths in men globally,
following lung cancer. The ACS reported in 2022 that prostate cancer accounted for
1,466,680 new cases and 396,792 deaths worldwide. The ACS also anticipates approximately
299,000 new cases globally in 2024, with 35,250 deaths projected in the United States alone.
The incidence and mortality rates are substantially higher in Black Americans than in Whites
or the general male population in the United States.[22] Incidence and mortality also increase
with advancing age, with the mean age at diagnosis being 66.[23]
The 2010 ACS guideline recommends that men with at least a 10-year life expectancy should
have the option to discuss prostate cancer screening with their healthcare provider. This
discussion should include information about the uncertainties, benefits, and risks associated
with serum prostate-specific antigen (PSA) testing, with or without a digital rectal exam
(DRE), to make an informed decision. Men at higher risk, including those with a family
history of prostate cancer (father or brother diagnosed with prostate cancer before age 65),
Agent Orange exposure, and Black American men, should be educated about prostate cancer
screening from age 45. Men at considerably higher risk (eg, prostate cancer diagnosed before
age 65 in multiple family members) should start receiving screening information from age 40.
[24]
When men face difficulty making decisions, healthcare providers may involve the patient's
family. The decision should be made considering the patient's overall health, preferences,
comorbidities, life expectancy, and willingness to pursue treatment if diagnosed with prostate
cancer. Asymptomatic men with a life expectancy of less than 10 years, determined by age
and health, typically should not undergo prostate cancer screening. For men opting for
prostate cancer screening following an informed, objective discussion of the pros and cons
(shared decision-making), the following measures are recommended:[25]
  The PSA test should be utilized with or without a DRE. However, in men with
hypogonadism, PSA with a DRE should be combined due to PSA's reduced
sensitivity in this group.
 The interval between screenings can be extended to every 2 years for men whose PSA
level is less than 2.5 ng/mL and yearly for men with a PSA level of 2.5 ng/mL or
higher.
 A referral for further evaluation or biopsy is recommended if the PSA level is 4.0
ng/mL or higher in men who are at average risk for prostate cancer. A second PSA
level should be obtained 30 days after the initial test for verification before
considering further investigation or a possible biopsy.
 If the PSA levels range between 2.5 and 4.0 ng/mL, the healthcare provider should
assess the individual's risk factors for developing high-grade prostate cancer and
decide, through a thorough shared decision-making discussion with the patient,
whether to make a referral for further diagnostic evaluation.
Factors that enhance the risk of prostate cancer are Black race, advancing age, family history
of prostate cancer, Agent Orange exposure, presence of a known BRCA2 mutation, Lynch
syndrome, elevated age-specific PSA level, low free % PSA, and abnormal DRE results. A
history of prior negative biopsies reduces the risk. Patients who decline further evaluation,
biopsies, or treatment, even in the presence of clinically significant cancer, are not ideal
candidates for prostate cancer screening. The 2018 USPSTF guidelines on prostate cancer
screening suggest discussing screening's advantages and drawbacks in men up to age 70.
However, several oncology and urology experts have raised concerns about this
recommendation. They argue that, based on US Social Security Actuarial tables, average
American men in good health do not reach a median 10-year life expectancy until age 77.
Moreover, these experts note that the USPSTF panel lacked representation from urologists or
oncologists and tended to overstate screening's risks while minimizing its benefits.
The American Urological Association suggests shared decision-making discussions for men
aged 70 to 80 regarding ongoing screenings, as per consensus. Continuing the screening of
men aged 80 and older is generally not recommended. However, exceptions can be made for
patients who understand the risks but wish to continue screening regardless. Please see
StatPearls' companion resource, "Prostate Cancer Screening," for further information.
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Issues of Concern
The ACS projects approximately 1.9 million newly diagnosed cancer cases and 609,360
cancer deaths in the United States in 2022. The cancer death rate increased until 1991, then
steadily declined through 2017, resulting in a 29% overall decrease and approximately 2.9
million fewer deaths than if peak rates had continued. This improvement was largely due to
long-term reductions in death rates for lung, colorectal, breast, and prostate cancers.
However, the decline in breast and CRC cases slowed for women and stopped for prostate
cancer from 2008 to 2017. In contrast, lung cancer cases in men declined more rapidly, from
3% annually between 2008 and 2013 to 5% annually between 2013 and 2017. Despite this
trend, lung cancer still caused more deaths in 2017 than breast, prostate, colorectal, and brain
cancers combined.
Even though CRC screening has improved compared to past rates, specific populations
significantly lag in screening practices, including:
 The uninsured, unhoused, migrants, and undocumented individuals with no accessible
source of healthcare
 People who have not visited a physician for a year due to financial, legal, personal,
logistical, dementia, or mental issues
 Non-Hispanic Asians
Considerable confusion about appropriate cancer screening remains, especially
where guidelines are conflicting and changing, such as for prostate cancer. Potential harms
from screening include false-positive tests, resulting in cancer overdiagnosis and
overtreatment. False-positive results also cause undue anxiety and subject patients to invasive
diagnostic testing. One strategy to avoid these problems is to target screening to high-risk
individuals, making cancer screening more cost-effective and balancing the benefit-to-harm
trade-off.
The ACS reports that colorectal, lung, and prostate cancers account for an estimated 48% of
all cancers expected to be diagnosed in men in 2024. For women, the 3 most common
malignancies are breast, lung, and colorectal, which will constitute an estimated 51% of all
new female cancer diagnoses in 2024. Overall, the cancer mortality rate in the United States
continues to decline slowly, although the incidence is increasing, with 2 million new cases
expected to be diagnosed in 2024. Worldwide, the overall cancer incidence is also rising,
with diagnoses expected to reach a yearly incidence of 29.9 million and 15.3 million deaths
by 2040.
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Clinical Significance
Cancer screening is initiated in an otherwise healthy population when the cancer risk
is substantial enough to justify the potential risks of overdiagnosis and overtreatment.
Cervical cancer screening has significantly decreased both the incidence and mortality rates
of the condition. Cancer mortality in the United States decreased by 25% from 1990 to 2015.
A significant decline has been noted in mortality rates for CRC (47% in men and 44% in
women) and breast cancer (39% in women), trends partially attributed to the introduction of
cancer screening for these diseases.[26] In addition, improved treatments for lung cancer
have also helped.
Early-stage breast, cervical, and CRCs have a 5-year survival rate ranging from 84% to 93%.
However, various studies have noted that certain population subsets are not aware of the
benefits of cancer screening. Community outreach programs that increase cancer awareness
and motivate people to discuss cancer risk and screening with a doctor will be tremendously
beneficial.[27] An estimated 611,720 cancer deaths are expected to occur in the United States
in 2024.
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Enhancing Healthcare Team Outcomes

Certain organizations, including the USPSTF and ACS, periodically review the available
evidence and update their recommendations as more trials demonstrate the real survival and
 mortality benefits of cancer screening and early diagnosis. Primary healthcare providers
should stay updated with changing screening guidelines. Primary care physicians are critical
in determining screening eligibility, engaging in informed decision-making discussions, and
coordinating care with specialists. Additionally, issues regarding insurance and affordability
should be addressed at the institutional level and by nonprofit organizations, while patients
should be guided to appropriate resources when available. Handouts distributed in clinics,
pharmacies, and common public places, such as grocery stores, have significantly increased
public awareness. Healthcare providers must now ensure they make appropriate
recommendations for screening patients based on published guidelines, patient age,
preferences, comorbidities, life expectancy, and risk factors.
2.
Developed by: • Walking Forward Program, John T. Vucurevich Regional Cancer Care Institute •
Native American Cancer Research • Cancer Information Service • Supported by National Cancer
Institute
3. Please turn off your cell phones or switch them to “vibrate” mode.
4. Cancer Screening & Early Detection Checking for cancer in a person who does not have any
symptoms of the disease is called screening.
5. Cancer Screening & Early Detection • The goal of early detection is to discover a cancerous tumor at
the earliest stage possible. • This way it can be stopped before it grows and spreads or metastasizes.
6. Screening Tests for Common Types of Cancer • Breast– Screening mammogram, clinical breast
exam, self-breast exam • Cervix - Pap test
7. Screening Tests for Common Types of Cancer • Prostate - Digital rectal exam, prostate specific
antigen blood test (PSA) • Colon - Fecal occult blood test, colonoscopy, sigmoidoscopy, digital rectal
exam
8. Barriers to Cancer Screening and Early Detection • Examples of barriers include: • Difficulties of
travel to the doctors and hospitals • Complicated health care system • Fear
9. Indian Health Service Reports on Cause of Death Cancer
10. Cancer Incidence Rates1999-2004 Source: Cancer registries in Centers for Disease Control and
Prevention's (CDC) National Program of Cancer Registries (NPCR) and National Cancer Institute's
(NCI) Surveillance, Epidemiology, and End Results Program (SEER) D. Espey, Monograph Group.
11. What Is Cancer?
12. Video: Cancer in the Great Land
13. Risk Factors • Cancer develops over time. It is a result of a combination of: • Lifestyle (daily
behaviors) • Environment • Heredity/genetics
14. Risk Factors Are Related to: • Frequency • How often? • Duration • How long? • Intensity • How
much?
15. Common Risk Factors for Cancer • Growing older • Tobacco abuse • Sunlight • Ionizing Radiation
16. Common Risk Factors for Cancer • Certain Chemicals and other substances • Some viruses and
bacteria • Certain hormones • Family history of cancer • Alcohol • Poor diet, lack of physical activity or
being overweight
17. Possible Symptoms of Cancer • There are many different symptoms known to be associated with
certain types of cancers. • A symptom is a sign that something is not right in the body. • It does NOT
always indicate cancer.
18. Possible Symptoms of Cancer,continued • A change in bowel or bladder habits • A sore that does not
heal • Unusual bleeding or discharge • Thickening, lump, or swelling in any part of the body •
Indigestion or difficulty swallowing • Recent change in wart or mole • Nagging cough or hoarseness
19. Possible Symptoms of Cancer, continued • Unexplained symptoms such as: • Progressive,
unexplained weight loss • Fever • Fatigue, feeling tired all the time • Pain
20. GUIDELINES FOR SCREENING ACS Guidelines for cancer screening for breast, prostate,
colorectal, and cervical cancer are provided in your packets.
21. Anatomy of the Prostate Gland
23. What Is the Prostate Gland? Male sexual gland It makes up part the fluid that allows the sperm to
swim / move It is about the size of a walnut in the shell
24. Prostate Cancer in Indian Country
25. Prostate Cancer Incidence Rates1999-2004 Source: Cancer registries in Centers for Disease Control
and Prevention's (CDC) National Program of Cancer Registries (NPCR) and National Cancer Institute's
(NCI) Surveillance, Epidemiology, and End Results Program (SEER) D. Espey, Monograph Group.
26. Haverkamp D, Espey D, Paisono R, Cobb N. Cancer Mortality Among American Indians and
Alaska Natives: Regional Differences, 1999-2003, Indian Health Service, Rockville, MD, Feb. 2008.
27. Prostate Cancer Risk Factors and Protective Behaviors
28. Known Risk Factors Age Family History Race Certain Prostate Changes Certain Genome Changes
29. Known Risk Factors Diseases/disorders (urinary tract infections) Chemical exposure (Cadmium
exposure; rubber industry More common in Northern Plains Genetics/family history
30. Possible Protective Factors Regular physical activity Healthy lifestyle choices, such as low-fat diet,
moderate to no alcohol use, and elimination of non-ceremonial tobacco use.
31. Screening for Prostate Cancer
32. Screening for Prostate Cancer Digital Rectal Exam (DRE): This is a physical exam of the prostate
gland. Prostate Specific Antigen (PSA) Test: This is a blood test to detect elevated levels of prostate
protein.
33. Digital Rectal Exam (DRE) Physical exam by the provider Recommended as part of annual checkup
for men over 50 years old Provider feels the prostate with a gloved finger through the wall of the rectum
Provider feels for Firmness Unusual lumps Uneven surfaces
34. Prostate Specific Antigen(PSA) Test Blood test Recommended as part of annual checkups For men
over 50 years old For younger men who are at high risk for the disease
35. What is the “PSA” Test? Levels higher than 4.0 ng/ml can be caused by conditions other than prostate
cancer A man who has prostate cancer will have higher PSA in the blood, because this is how his body
fights the disease
36. What Besides Prostate Cancer Can Cause High PSA Levels? Benign Prostatic Hyperplasia (BPH) –
enlarged prostate Infected or inflamed prostate Biopsy or operation on prostate Pre-cancerous cells in
the prostate
37. Where Is Prostate Cancer Screening Available in the Northern Plains? Any health clinic with a lab
Veterans Administration (VA) Hospitals and outreach clinics Indian Health Service Clinics Tribal or
Urban Indian clinics Ask if anyone is qualified to do a digital rectal exam (DRE) Rural health clinics
38. Where Can I Get a PSA Blood Test? IHS VA Community Programs Medicare/Medicaid Private
Insurance
39. Prostate Cancer Screening Results Make sure you get your results!!
40. Symptoms that May Be Related to Prostate Cancer
41. Prostate Cancer Symptoms Urinary problems (trouble passing your water) Not being able to urinate
Having a hard time starting or stopping the urine flow Need to urinate often, especially at night Pain or
burning during urination Blood in the urine
42. Prostate Symptoms Frequent pain in the lower back, hips, or upper thighs Difficulty having an erection
43. Basics of Cancer Treatment
44. Cancer Treatment • Treatment for cancer depends on several factors: • Type of cancer • The size,
location, and stage of the disease • General health of the individual
45. Cancer Treatment • Treatment for cancer can be either local or systemic. • Local treatment affects
cancer cells in the tumor and the area near it • Example: radiation therapy • Systemic treatment travels
through the bloodstream reaching cancer cells all over the body • Example: chemotherapy
46. Cancer Treatment • Treatment methods may include: • Surgery: Removal of the cancerous tumor and
possibly the surrounding tissue and lymph nodes near the tumor • Chemotherapy: the use of drugs to kill
cancer cells
47. Cancer Treatment • Radiation Therapy: The use of high-energy rays to kill cancer cells or stop them
from growing and dividing • Hormone Therapy: Used against certain cancers that depend on hormones
for their growth • Biological Therapy (Immunotherapy): helps the body’s natural ability to fight disease
(immune system), or protects the body from some of the side effects of cancer treatment
48. Cancer Treatment • The treatment plan may also include the use of clinical trials. • Clinical trials are
research studies that evaluate new treatments and answer scientific questions about them.
49. Give Yourself a Hand!Thank YOU!!!!

 Related
 More by User

Breast cancer screening

kasinamrao@gmail.com. 2. . Breast cancer screening. Early detection is an important factor
in the success of breast cancer treatment. The earlier breast cancer is found, the more easily
and successfully it can be treated. The three methods commonly used for early detection are:
Breast self-exam (BSE). Clinical breast exam (CBE).Mammogram..

1.56k views • 32 slides

Cancer screening
560 views • 29 slides

Bowel Cancer Bowel Cancer Screening Education and Awareness Sessions

Bowel Cancer Screening Programme. Maureen SayerHealth Improvement
PractitionerCheshire and Merseyside Bowel Cancer Screening Programme. AIMS and
Outcomes: Increased awareness of the signs and symptoms of bowel cancer Increased
understanding of the Bowel Cancer Screening Programme (BCSP) Incre

789 views • 52 slides

Breast Cancer Screening

Breast Cancer Screening. Steven Stanten MD Rupert Horoupian MD AltaBates Summit
Medical Center Oakland, California. Incidence. USA - 2008 184,450 new cases of invasive
ca 40,930 deaths 3 decade increase Wide spread screening Increased dx of non-invasive and
pre-malignant lesions.

1.11k views • 75 slides

Breast Cancer Screening
Is There a Conflict of Interest Anywhere. In keeping with the Main Pro 1 Credit
Requirements of the College, I have to tell you that I have no conflict of interest in giving this
talkNo animals were harmed in the making of this slide presentation. Here Is What We Are
Going To Talk About. Epidemiol

557 views • 45 slides

Cervical Cancer Screening

Cervical Cancer Screening. Dale Akkerman Ob/Gyn, Burnsville office. Remember. Goal of
cervical cancer screening program is to detect neoplasia to allow intervention to prevent early
invasive cervical cancer and to reduce mortality Goal is not to prevent any or all abnormal
cytologic reports.

649 views • 32 slides

Lung Cancer Screening

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904 views • 42 slides

Colorectal Cancer Screening

Colorectal Cancer Screening. Matt Clausen, MS3. Diagnostic Radiology Elective, December
2007. Clinical Significance. Disease Burden—Estimates for 2007 1

1.19k views • 43 slides

OVARIAN CANCER SCREENING :
OVARIAN CANCER SCREENING :. Edward J. Pavlik University of Kentucky Ovarian
Cancer Screening Research Program July 26, 2011. CANCER SCREENING: Definitions.

1.15k views • 58 slides

Prostate Cancer Screening

Prostate Cancer Screening. Google Search “Prostate Cancer”. “Google Health” prostate
cancer (OK) “Should All Men Be Screened for Prostate Cancer?” ABC news. Prostate
Cancer Review. Most common non-dermatologic malignancy in US men 2 nd most common
cause of cancer related death in US men

643 views • 25 slides

BREAST CANCER SCREENING

BREAST CANCER SCREENING. Anoop Agrawal, M.D. NEW USPSTF BREAST
SCREENING GUIDELINES. Published by US Preventative Screening Task Force in
November 2009. Last published in 2002. Other organizations who publish breast screening
guidelines include: American Cancer Society

1.15k views • 17 slides

Colorectal Cancer Screening

Colorectal Cancer Screening. John Pelzel MD Sleepy Eye Medical Center. Why do we
Screen? -Colorectal cancer (CRC) is the third most common type of cancer -CRC is the 2 nd
leading cause of cancer death in the United States (in 2008 CRC accounted for over 600,000
deaths)

351 views • 11 slides

Cervical Cancer Screening

Cervical Cancer Screening. Cristin Colford, MD April 27,2010. This is why I do this talk….
Sent: Wednesday, July 02, 2008 11:24 PM To: Colford, Cristin Subject: Questions

556 views • 36 slides

Cervical Cancer Screening
Cervical Cancer Screening. Presenter: Lesley Dyck. Web, General - 2010 Manitoba Cervical
Cancer Screening Program. www.TellEveryWoman.ca. What do you already know about
cervical cancer screening?. www.TellEveryWoman.ca. Female body.
www.TellEveryWoman.ca. Female body. True or False?.

1.04k views • 47 slides

Cancer Screening
Cancer Screening. Benefits Prevent development of disease Early detection can help improve
prognosis (treatment at earlier stage + before symptoms appear) Considerations tests can
yield false-positives (or false negatives) screening procedures can come with risks

550 views • 35 slides

Breast cancer Screening

Breast cancer Screening. NHS Breast Screening Programme NHSBSP Publication No. 61.
Feb 2006 www.cancerscreening.nhs.uk. NHS Breast Screening Programme (NHSBSP) began
in 1988 Aims to invite all women aged 50-70 years once every 3 years

583 views • 7 slides

Breast Cancer Screening

Breast Cancer Screening. Talking about things can make them real. Let’s talk about
supporting each other to stay healthy. Breast cancer facts. In 2008, 2,000 new cases of breast
cancer are expected in Alberta 8 out of 10 breast cancers occur in women age 50 and over

729 views • 29 slides

Cancer Screening
Cancer Screening. Carrie Horwitch MD, MPH What’s New in Medicine Sept 13, 2014
Carrie.horwitch@vmmc.org. Objectives. Review current guidelines for cancer screening for
average risk person Cervical Colon Breast Lung Prostate Discuss when to stop screening
847 views • 59 slides

Breast cancer screening

Breast cancer screening. Mammography is the most widely used screening modality, with
solid evidence of benefit for women aged 40 to 74 years Clinical breast examination and
breast self-exam have also been evaluated but are of uncertain benefit

651 views • 8 slides

Cervical Cancer Screening

Early detection and eradication of HSIL is one of the most effective ways of preventing and
controlling cervical cancer.

177 views • 9 slides

Cervical Cancer Screening

Cervical Cancer Screening. Dale Akkerman Ob/Gyn, Burnsville office. Remember. Goal of
cervical cancer screening program is to detect neoplasia to allow intervention to prevent early
invasive cervical cancer and to reduce mortality Goal is not to prevent any or all abnormal
cytologic reports.

496 views • 32 slides

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