Cervical Cancer Screening

Screening for Cervical Cancer (Pap Smears)
Cervical cancer is the easiest female cancer to prevent, with regular screening tests and follow up. Two screening tests can help prevent cervical cancer, or find it early:
1. The Papanicolaou (Pap) Smear – looks for cell changes on the cervix that could become cervical cancer if not treated appropriately. It involves inserting a speculum into the vagina, and collecting a sample from the cervix using a brush.
2. HPV (Human Papillomavirus) test – looks for the virus that can cause these cell changes. This test is run along with your Pap smear; it does not require separate time or collection apparatus.
In 2012, the American Cancer Society, the U.S. Preventative Services Task Force, and the American College of Obstetricians and Gynecologists published the following guidelines for cervical cancer screening for the average-risk woman.
1. Begin Pap smears at 21 regardless of age of onset of sexual activity. Women younger than 21 should NOT be screened.
2. Pap smears should be performed every 3 years from 21-65 years of age. Please note, physical exams are still recommended every year, which may include visualization of the external genitalia and/or speculum examination of the vagina without collection of a Pap smear.
3. HPV screening should start at 30 years old and occur every 5 years.
4. Stop Pap smears after 65 years old if there has been adequate screening up to that age.
5. Women who have had a total hysterectomy (cervix and uterus removed) should stop screening. Women who have a cervix left intact following hysterectomy should continue screening according to guidelines.
6. Women who have received the HPV vaccination (Gardisil) should be screened according to the same guidelines.
These guidelines were based on large studies, improved screening tests, and a better understanding of the cause and natural progression of cervical cancer. If you have abnormal results on a Pap smear, you may need further testing or interventions.
The only cancer for which the Pap smear screens is cervical cancer. It does not screen for ovarian, uterine, vaginal, or vulvar cancers. Your doctor can determine if you need additional testing for these other types of cancers.
For further information, please visit the following websites:
http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer
http://www.uspreventiveservicestaskforce.org/uspstf11/cervcancer/cervcancersum.htm
http://www.acog.org/About_ACOG/Announcements/New_Cervical_Cancer_Screening_Recommendations

Prostate Cancer Screening

PROSTATE CANCER SCREENING
In 2012 the U.S. Preventative Services Task Force determined that men of any age should NOT have prostate cancer screening using the PSA blood test, with or without digital rectal examination. This recommendation was based on evidence that the potential harms of screening outweighed any potential benefit.
• Prostate cancer is the second most common cancer in men, but in most cases it does not grow or cause symptoms. Treatment for prostate cancer is often unnecessary.
• The PSA screening test often suggests that prostate cancer may be present when there is no cancer (A “false-positive” result).
o Men with a positive PSA still only have about a 1% chance of having prostate cancer.
• Follow up testing for positive PSA results can cause:
o Worry and anxiety
o Fever, infection, bleeding, urinary problems, pain
o Hospitalization
• Cancers that are detected are often treated because there is no way to currently tell for sure if a cancer is aggressive or not. This means many cancers will be treated unnecessarily with surgery, radiation, and/or hormone therapy. Potential side effects of treatment include:
o Erectile dysfunction (impotence)
o Urinary incontinence
o Problems with bowel control
o A small risk of death and serious complications from surgery
Therefore, prostate cancer screening with a PSA blood test is more likely to cause harm than benefit.
If you have further questions, or feel strongly that you should be screened for prostate cancer, please talk with your doctor.
For more information, please see http://www.uspreventiveservicestaskforce.org/prostatecancerscreening.htm