3 Cancer Screenings Every Adult Should Get

By Ranit Mishori, MD, Special to Everyday Health

Cancer, in its various forms, is scary. Though the medical world has come a long way in diagnosing and treating many forms of the disease, cancer remains something everyone wants to prevent — or if that’s not possible, find early and treat quickly.

What we all want is an early warning system — some sort of test that definitively reveals cancer’s presence. In fact, there are several tests, including mammograms, colonoscopies, and Pap smears, that can give that early warning: finding cancer before it can cause symptoms or, worse, before it spreads and cannot be contained, possibly leading to death.

However, new data from the Centers for Disease Control and Prevention (CDC) reveal that many adults in the United States are not getting the recommended screening tests for breast, colorectal, and cervical cancers. The analysis found that:

• One in five women ages 21 to 65 reported not being up-to-date with cervical cancer screening.
• Nearly one in four women ages 50 to 74 say they are missing out on recommended mammograms, which can detect breast cancer.
• Two in five adults ages 50 to 75 reported not following clinical recommendations for colorectal cancer screening.

Cancer Screening Caveats

While the screening tests for breast, colorectal, and cervical cancers can and do help catch many cancers early, it’s important to know that none of them is 100 percent reliable.

All have the possibility of missing an existing cancer (a “false negative”) or detecting something that turns out to not to be cancer (a “false positive”).

Either of these erroneous results can be harmful:

• False positives can cause anxiety and lead to unnecessary procedures such as biopsies, which can cause bleeding, infection, and pain.
• False negatives can cause delays in treatment, possibly allowing cancer to spread before it is detected.

Screening tests may also be read or interpreted incorrectly, or their accuracy may be compromised by quirks in the technology or the machines used to conduct them.

Personal anatomical and physiological differences (how dense a woman’s breasts are, for example) may also affect the accuracy of screening test results.

The Cancer Screenings You Should Get

Doctors, scientists, biostatisticians, and epidemiologists have been working together to determine which cancer screening tests have the best chances of identifying true disease, so that measures can be taken to treat cancer before it spreads and causes much harm.

One such group is the U.S. Preventive Services Task Force (USPSTF), an independent body that thoroughly and systematically examines the medical evidence and periodically produces screening recommendations to help clinicians determine which screening tests to perform, when, to whom, and how frequently.

If you are an adult with an average risk for cancer (there are no particular factors that may make you more likely to have cancer, such as a family history), here are some cancer screening tests all professional societies agree you should consider and discuss with your doctor, because evidence exists that they can save lives:

Benefits of Cancer Screening Tests

While cancer screening tests don’t prevent cancer, they can lower the number of deaths from cancer by catching it early so that treatment can start early.

Colorectal cancer. According to the American Cancer Society (ACS), colorectal cancer is the second-leading cause of cancer-related deaths in the United States for men and women combined. For 2015, the ACS predicted the toll of colorectal cancer to be:

• 93,090 new cases of colon cancer
• 39,610 new cases of rectal cancer
• 49,700 deaths from colorectal cancer

Breast cancer. Breast cancer is the most common cancer among women in the United States and the second leading cause of cancer-related death among U.S. women, says the ACS. The predicted 2015 toll:

• 231,840 new cases
• 40,290 deaths

Cervical cancer. Rates of cervical cancer,  a cancer that affects only women, have decreased dramatically in recent decades with the introduction of the Pap smear. Nonetheless, the ACS estimates the toll of cervical cancer in 2015 will be:

• 12,900 new cases
• 4,100 deaths

Cancer Tests Not Ready for Prime Time

While it’s important to be screened for breast, colon, and cervical cancer as recommended, not all cancer screening tests are worth having.

The following cancer screening tests, for example, are considered very inaccurate, and many experts agree that the potential harms of screening often outweigh the benefits:

Prostate cancer. A blood test called the prostate-specific antigen (PSA) test is sometimes used to screen for prostate cancer in men. However, the USPSTF gives it a grade of D (not recommended). Nonetheless, despite the overwhelming evidence that suggests significant potential harms and only very small potential benefits, some physicians, professional organizations, and individuals are still in favor of doing PSA tests. Before you have a PSA, ask your doctor about the pros and cons.

Bladder cancer. Testing urine to detect signs of bladder cancer was once the norm. Recent systematic studies, however, have shown little to no benefit of screening for this form of cancer, and screening is currently not recommended by the USPSTF.

Ovarian cancer. Many women are understandably worried about one of the deadliest forms of cancer, ovarian cancer. It is often discovered late, after it has spread to nearby organs or beyond. Unfortunately, there are currently no accurate screening tests that can detect it early.  Physicians and scientists almost universally agree that the options previously tried (pelvic ultrasound and a blood test to measure levels of a tumor marker called CA-125) are ineffective for early detection of ovarian cancer and should be avoided. The USPSTF gives it a grade of D (not recommended).

Cancer Prevention That Works

Researchers are constantly gaining new insights about cancer screening, and they continue to look for more reliable and precise methods and technologies to detect cancer early enough so that it can make a difference in people’s lives.

Until better screening tests become available, remember that no cancer screening test is perfect. Ask your doctor about the potential benefits as well as potential harms of any screening test, even those that are universally recommended.

Meanwhile, there’s a lot you can do to prevent cancer:

• Don’t smoke.
• Exercise regularly.
• Follow a healthy diet and don’t overeat.
• Drink alcohol in moderation.
• Limit your sun exposure and don’t use tanning beds.

And try to avoid or limit your exposure to such environmental cancer-causing substances as:

• Radon, a naturally-occurring, radioactive gas that can build up in confined spaces such as houses, particularly in the basement and first floor. Inexpensive radon test kits are available, and a variety of techniques can be used to reduce radon levels in a house or other building.
• Asbestos, a group of minerals used for many years in construction products and still present in many buildings. Removal or major repairs of asbestos-containing materials should be done by an accredited asbestos professional.