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Cancer Screens: Are We Better Off?

The short answer is YES!

“An estimated 3.2 million U.S. cancer deaths have been averted since 1991 because of improvements in early detection, and treatment, as well as reductions in smoking.”https://prescancerpanel.cancer.gov/reports-meetings/cancer-screening-report-2022/challenges-opportunities

Breast cancer deaths have gone down by 50% in the U.S. between 1975 and 2012 with the use of mammogram screening, along with advances in treatment.

Cervical cancer deaths have dropped by nearly 60% from 1975 to 2017 in the U. S. with the widespread use of Pap tests and, more recently human papillomavirus testing that accompanies the Pap test.

Colorectal cancer deaths have declined by more than 33% over the last 30 years and this trend has been credited to expansion of colorectal screening in the U.S. via colonoscopy, sigmoidoscopy, and stool-based tests such as fecal immunochemical tests(FIT).

Lung cancer deaths also have declined by 20% in high-risk individuals with the annual low-dose CT cancer screening that the USPSTF(U.S. Preventative Services Task Force) most recently started in 2013.

https://prescancerpanel.cancer.gov/reports-meetings/cancer-screening-report-2022/challenges-opportunities

I highly recommend that all of us follow the guidelines of doing breast, cervical, colorectal, and lung cancer screens. If I may, I have a few anecdotes about the subject of cancer screens.

I found out that this particular individual had not done a Pap test in over 10 years or so. With some prompting, she had her Pap cancer screen test done. The Pap cancer screen turned out to be abnormal. This led to her getting a biopsy that, although it was positive for cervical cancer, it was thankfully still at an early stage. Her cancer had not yet metastasized, and removing her uterus surgically(she was not planning on having more children) turned out to be a curative treatment.

Another example was that of a patient who was not as fortunate. By the time that I first saw him, he had already been diagnosed with colorectal cancer that had metastasized. He went on to die shortly afterward. I asked him during that one visit if he had known about colon cancer screening via colonoscopy. He said that his primary doctor had recommended it, but that he had been non-compliant about going through with the procedure.

My impression on the need for cancer screens, however began even before I started practicing medicine. I was in medical school in the late 1970s and I vividly remember a surgeon teacher who was to give a talk about the topic of colon cancer. He got to the lecture hall late because he had just finished doing surgery on a patient with colorectal cancer. He started talking in a very frustrated tone about the patient he had just finished operating on and about the many other similar patients that he had done colorectal cancer surgery as well. He mentioned that the majority of these patients were not going to survive because of their late-stage disease. He was at a loss as to what to do to catch the colon cancer sooner. It was shortly after this, in the early 1980s, that sigmoidoscopy cancer screening(precursor to colonoscopy cancer screening) would start.

Without a doubt lives are being saved with cancer screening of breast, cervical, colorectal, and lung. This is information that will help anyone of us be healthier.