With the great advances in medical care in recent years, many of them related to early detection of disease, it makes more and more sense for residents of Dallas, Houston, Austin and throughout Texas to take advantage of what is available, Those who do so are more likely to live longer, some experts say.
History supports the idea with at least one example, the death rate associated with cervical cancer. Fifty years ago, cervical cancer was responsible for killing more women than any other form of cancer. When medical science developed the Pap test, which can identify cervical cancer before it starts, the death rate began going down; today cervical cancer is number 15 on the list of cancers that kill American women.
Not every test is perfect, say experts, and that goes for the Pap test. For every five women who have cancerous or precancerous cervical cells, at least one will have a test mistakenly reported as normal, according to the National Institutes of Health. Because this type of cancer develops slowly, a woman’s next test should be a better indicator, but a so-called “false negative” can result in a delay, which could be dangerous when it comes to diagnosis and treatment.
Another common test that can have lifesaving benefits for Texans is the colonoscopy, which is performed by a doctor inserting a flexible, lighted tube into the rectum and guiding it into the colon to look for and remove growths called polyps, the source of most colon cancers.
While the Centers for Disease Control reports a drop in deaths from colon cancer from more than 57,000 in 2000 to 53,580 in 2004, one problem identified by some researchers is that doctors who do the exam too quickly won’t see the full benefit of the screening.
In doing colonoscopies, experience is seen to be a factor. Some experts suggest asking the physician how many colonoscopies are done in a typical morning. Ten is a reasonable number, the experts say.
Another test known to be effective in saving lives is the screening for human papilloma virus. Commonly referred to as an HPV test, the procedure indentifies the virus responsible for most cases of cervical cancer. The HPV test is used with the Pap to screen women over the age of 30, and is used to assess whether they have been infected with any of the 13 HPV types that are linked to the cancer. The HPV test is also suggested for younger women if a Pap test shows there is a possible problem.
Testing for breast cancer includes having a mammogram, one of the more basic methods of screening. While mammograms have generated some controversy, the result of a Danish research study that said there was no good evidence behind its widespread use, both the American Cancer Society and the National Cancer Institute have since come out in favor of the test for women, starting at age 40.
For women 50 and older, the U.S. Preventive Services Task Force reports that an annual mammogram cuts the risk of dying of breast cancer by at least 16%. The test does have its flaws, however, including the potential for it to indicate an abnormality when one isn’t really there. While the argument can be made against getting a false alarm, what is more worrisome are surveys showing that, in about 20% of cases where cancer is present, a mammogram doesn’t detect it.
Patients who remain concerned are sometimes encouraged to ask for a double-check of an x-ray. Another strategy is to ask the testing facility about its reading practices. Some experts say that x-rays should ideally be read by two radiologists or scanned by computer-assisted detection technologies which can improve the accuracy of the tests.
Some experts also suggest that women who are at higher risk have an MRI done each year, the idea being that higher detection rates typically come from the MRI versus a mammogram. In a study by Ellen Warner, MD, a medical oncologist at Toronto Sunnybrook Regional Cancer Centre in Ontario, the MRI found 77% of cancers, compared with 36% detected by mammography. At the same time, women at average risk are not encouraged to get an MRI because of a high false-positive rate — it often signals cancer when none is present.
Not all news on the cancer front is good news.
One standout point of concern is with melanoma, a dangerous form of skin cancer that has the distinction of being the only cancer that can be screened for that is on the increase, both in the number of new cases and in the death rate.
The American Cancer Society suggests getting a once-over for melanoma at every checkup. Because melanoma can occur in surprising spots that are difficult to examine yourself, like the eyes, gums, and genitals, experts say a full-body check is the best protection. Patients should take advantage of routine exams by asking their dentist, eye doctor, and gynecologist to look for pigmented lesions or other suspicious changes.
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