Breast, Cervical, Colon Cancer Screenings Explained


Despite the uncertainty of self-exams, a woman should always see her health care provider if she feels a lump, hard knot or thickening, swelling, warmth, redness or darkening, change in the shape or size of the breast, dimpling or puckering of the skin, an itchy, scaly rash on the nipple, the pulling in of the nipple or other part of the breast, sudden nipple discharge, or a new pain in the breast that doesn't go away.

But it's important to know that screenings do not come without risk. Dr. Anne Wallace, director of the breast care unit at the University of California at San Diego, said that many doctors feel that anxiety sometimes outweighs the benefits with early screening.

Only about 20 percent of women who have follow-up biopsies are found to have cancer, said Wallace.

"But if you're that 41-year-old who has a high-grade cancer, you don't care about the numbers because you have a two-year-old at home," said Wallace. "We're talking very valuable lives raising children that cost society a great deal if we were to lose that life."

When asked if she thought that women can get over screened, Dr. Diane Harper replied, "Absolutely yes." Harper is director of the Gynecologic Cancer Prevention Research Group at University of Missouri-Kansas.

And Burstein, from Dana-Farber, agreed.

"The greatest risks relate to false-positive findings, wherein there is an abnormality seen that requires further testing or biopsy and which proves to be benign," said Burstein. "For many women, the experience of getting the mammogram is physically uncomfortable, and stressful."

Cancer Screenings Come With Benefits, Risks

Women should know the risks and also the benefits of screenings, said Wallace. There is no doubt that mammograms have saved many lives.

It's important to note that some doctors recommend women ease up on the screening if they are in their elderly years without prior signs of cancer.

"Women, as they get older, should stop being screened when it's not considered useful to know the answer," said Bear. "If you found a little cancer that may be clinically evident in five years, but the person is not likely to live for another five years, then they probably don't need to be screened, but that is something subjective and should be discussed with family."

Cervical Cancer Screenings

Women should begin cervical cancer screening about three years after having vaginal intercourse for the first time, or no later than 21 years old.

The American Cancer Society also recommends that a 30-year-old woman who has had three normal Pap test results in a row can lower the screening schedule to every 2 or 3 years. And women aged 70 years of age or older who have had three or more normal Pap tests in a row and no abnormal results in the last ten may choose to stop getting Pap tests altogether.

"Paps seems to be most important in younger women, so the test doesn't seem as necessary the older that people get, but it all depends on HPV status and results," said Wallace.

The most important risk factor for cervical cancer is the human papilloma virus, or HPV. The virus can infect cells on the surface of the skin, genitals, anus, mouth and throat. It can be spread during sex, but a person can also contract it through skin-to-skin contact with an area of the body infected with HPV.

HPV is also associated with vaginal, vulvar and anal cancers in women.

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