WHAT IS CANCER SCREENING?
Cancer screening refers to tests that can be done to look for signs of cancer or to see if you are likely to develop cancer. There are 2 types of cancer screening tests: early detection tests and preventive screening tests.
Early detection tests look for cancer that already exists, trying to find it early. Mammograms are an example of an early detection test because they can find breast cancer when it is still really small.
Preventive screening tests look for growths or cells that are likely to become cancer. Pap tests are an example of a preventive screening test. Pap tests can find precancerous cells before they become cancer and when they can still be removed so that the cancer never develops. Another example of a preventive screening test is a colonoscopy, which can find growths in the colon called polyps and remove them before they turn into cancer.
WHY IS CANCER SCREENING IMPORTANT?
Cancer screening saves lives. There have been many advances in cancer treatment over the past few years. Cancer no longer has to be a death sentence. Early treatment often results in a cure. Many people are now living well after a cancer diagnosis, often because their cancer was diagnosed and treated very early. For example, a small breast cancer may be seen on a mammogram up to 2 years before it can be felt with a breast exam. The cancer can then be treated early, increasing the chances for cure.
WHAT ARE THE RECOMMENDED TESTS?
Screening tests that have been shown to have benefit are:
· breast mammograms to check for breast cancer in women
· Pap tests for precancer or cancer of the cervix (the opening of the uterus)
· fecal immunochemical test (FIT) can find small traces of bloodsigmoidoscopy or colonoscopy for prevention or early detection of cancer in the colon or rectum
Healthcare providers may offer a yearly rectal exam and PSA blood test to screen men age 50 to 75 for prostate cancer. Men should discuss the benefits and harms of these tests with their healthcare provider. At this time there is not enough evidence that screening all men is helpful.
Comparing mammograms from year to year can help detect early cancer. National Standards and Guidelines for Breast Screening released by the Canadian Association of Radiologists (CAR) recommend a mammogram annually for women 40 to 49. Women 50-69 are recommended to have a mammogram every 2 years; some women in this age group may have annual screening if risks identified (example: strong family history). Women 70 and older are recommended to continue to have screening if they are in good health.Ask your healthcare provider when you should start having mammograms and how often you should have them.
Women can refer themselves for a mammogram through theNova Scotia Breast Screening Program which is available to asymptomatic (have no symptoms) women over the age of 40 who have a valid health card. To book an appointment have your healthcare ready and call (Halifax Regional Municipality: 902-473-3960 or toll-free: 1-800-565-0548), or visit their web site at: http://breastscreening.nshealth.ca/.
Prince Edward Island:
Comparing mammograms from year to year can help detect early cancer. For women 40-49, speak with your primary care provider about your risk of breast cancer, along with the benefits and risks of mammography. For women 50-69, have a mammogram every 2 years. For women 70 and older, speak with your primary care provider about how often you should have a mammogram.
For breast cancer screening program details or to book an appointment call: PEI Breast Screening Program – 1-888-592-9888 or visit website: http://getscreenedpei.ca
The recommendations for how often a woman should have a Pap test depend on age and previous test results.
· Women who have been sexually active should start having a Pap test at the age of 21. Once women begin having Pap tests, they should have them every three years.
· Women who become sexually active for the first time after the age of 21 should have a Pap test within three years of the time that they became sexually active.
· Women who have never been sexually active do not need to have Pap tests until such time as they become sexually active.
· If the Pap test results are normal (negative or clear) women should continue to have Pap tests every three years.
· Screening may be discontinued after the age of 70 ONLY if there is an adequate negative screening history in the previous ten years (i.e. three or more negative tests).
Screening women with special circumstances:
Women who have been TREATED (by LEEP, laser, cryotherapy, cone, hysterectomy) for cervical dysplasia, have a history of cancer of the cervix or are immunocompromised or HIV positive should receive annual screening for life.
Prince Edward Island
· If you’re sexually active, you should start having regular Pap tests starting at age 21.
· You’ll need a Pap test every 2 years, depending on your previous test results.
· Even if you have stopped having sex, you should continue to have a Pap test.
· If you’ve had a hysterectomy, you may still need a Pap test, but talk to your doctor about whether this is necessary.
For information about cervical cancer screening speak with your primary care provider or arrange an appointment by calling the PEI Pap Screening Program at 1-888-561-2233.
Fecal immunochemical test (FIT)
At age 50 men and women should start having fecal occult blood testing to screen for colon and rectal cancer. The samples will be tested for blood. If there is blood in the samples, it usually does not mean you have cancer, but it does mean you will need more tests to see what is causing the blood in your bowel movements.
The FIT looks for very small amounts of blood in your stool. You simply place a sample of your stool on a test card and return it, along with the Participant Form, to the lab in the postage-paid envelope. The lab will analyze the test and send a letter with your results to you and your doctor or nurse practitioner.
The Colon Cancer Prevention Program mails out screening tests to everyone in Nova Scotia aged 50 – 74 years old.
All healthy people aged 50 – 74, with no family history of colon cancer, should be screened every two years.
People with warning signs of colon cancer (such as blood in the stool or changes in bowel habits) and those who have a family history of colon cancer should talk with their primary care provider who will arrange for the most appropriate screening test based on their history.
To learn more about the Colon Cancer Prevention Program, call toll-free at 1-866-599-2267.
Prince Edward Island
This test checks your stool for blood that you may not know is there and helps to identify polyps before they become cancerous. You can pick up a FIT KIT at any family health centre or medical clinic on P.E.I. It’s a simple process you do at home and return to your family health centre or local hospital for testing. Results will be mailed to you directly.Please visit this website to find the centre closest to you: http://www.healthpei.ca/healthcentres
You are of average risk if you:
· Are 50-74 years of age
· Do not have family history of colorectal cancer (parent or sibling)
· Are not experiencing any signs or symptoms such as changes in bowel movements, visible blood in your stool or excessive vomiting.
You may be of increased risk and should consult your family doctor or health professional if you:
· Have a family history of colorectal cancer
· Have a personal history of colorectal cancer or polyps
· Are experiencing any of the following symptoms:
· change in bowel movements
· blood (bright red or very dark) in your stool
· long standing diarrhea or constipation
· weight loss or fatigue
· extreme vomiting
Sigmoidoscopy and colonoscopy
Sigmoidoscopy and colonoscopy are procedures that look for precancerous or cancerous changes in your colon and rectum. A slim, flexible, lighted tube is inserted into your rectum to view the inside of these organs. Discuss this with your healthcare provider.
Sometimes a test called a barium enema may be used instead of a sigmoidoscopy or colonoscopy to look for colon cancer.
Digital rectal exam and PSA test
For the digital rectal exam, the healthcare provider puts a gloved finger in a man’s rectum to feel the prostate gland. Prostate cancers feel very hard compared to normal prostate tissue. If your provider feels something abnormal, then you may have other tests to see if there is a tumor and whether it is a type of cancer that will spread.
The PSA (prostate specific antigen) level in the blood usually rises when a man has cancer of the prostate gland. However, it also rises if the prostate is infected or enlarged. Enlarged prostates are common in middle age and later. The test can give misleading results and cause anxiety, expense, and unnecessary medical procedures. For this reason, the PSA test is not recommended as a general screening test. Research is ongoing to see when and how PSA might be helpful as a screening test for prostate cancer. Whether you should have a PSA test is something you should discuss with your provider.
For more information:
ARE THERE OTHER SCREENING TESTS?
If breast cancer occurs often and at younger ages in your family, you may choose to have a BRCA gene test. A changed form of this gene may greatly increase your risk of breast cancer. The BRCA gene test can show if you have inherited this gene. More frequent breast cancer screening may be recommended for women who have this gene. Some women who have BRCA1 or BRCA2 genes choose to have their breasts removed to keep from getting breast cancer.
HOW CAN I KNOW WHEN I SHOULD HAVE SCREENING TESTS?
Which tests you have and the timing of these tests depend on your personal and family history. Be sure your healthcare provider knows your family history. Ask your provider which cancer screening tests you need and how often.
For more information on cancer screening contact Cancer Care Nova Scotia at firstname.lastname@example.org or call toll-free at 1-866-599-2267, or visit the Cancer Care Nova Scotia website at http://www.cancercare.ns.ca/en/home/preventionscreening/preventingcancer/default.aspx
Prince Edward Island
For more information on cancer screening contact the Canadian Cancer Society at 1-866-566-4007 or visit their website at http://getscreenedpei.ca/