Which cancers can be detected through early screening? (2)

Cancer screening for high-risk populations

As for the early screening of cancer, let’s talk about [machine gun-fired] cancer screening, and then let’s talk about [sniper rifle-fired] cancer screening, that is, screening only for high-risk groups. The significance of such screening is not as clear as [machine gun-fired] screening. Whether it can improve the survival rate of cancer patients and reduce the cancer mortality rate is still controversial.

The following list of lung cancer, prostate cancer and endometrial cancer is introduced one by one:

I. Lung Cancer

Lung cancer is the most common form of cancer in China, It is also the cancer with the highest mortality rate. Most lung cancer patients, At the time of discovery, it was advanced and the therapeutic effect was not good. The United States is currently conducting an experiment on low-dose chest CT screening for lung cancer in 500,000 people. Preliminary results show that the death rate of lung cancer patients found after low-dose CT screening in high-risk groups is 16% lower than that found by X-ray examination, but the final results have not yet come out.

At present, for high-risk lung cancer patients, it is recommended to check low-dose chest CT once a year for screening. At the same time, those with the following three items are high-risk groups that need screening.

1. 55-74 years of age

2. Good health

3. 30 packs of smoking history, and smoking or quitting smoking for less than 15 years.

Package year refers to the number of packets smoked per day multiplied by the number of years of smoking. For example, 30 packet years can be two situations: smoking 3 packets per day for 10 years (3 × 10), or smoking 2 packets per day for 10 years, then smoking 1 packet per day for 10 years (2 × 10 + 1 × 10).

Second, prostate cancer

Whether prostate cancer needs screening, It is a problem that puzzles scientists very much. Because prostate cancer is different from other cancers, It’s very slow. Even with prostate cancer, In most cases, Most of the patients still die of other causes in the end, However, it has nothing to do with prostate cancer. Many people often find prostate cancer through autopsy, and they knew nothing about it before their death. Therefore, even if there is a way to find prostate cancer early, whether to treat it after diagnosis is very difficult for doctors. Whether prostate cancer screening can eventually prolong the life span of patients is still controversial.

The medical profession generally recommends that men over 50 years old can consult a doctor about prostate cancer screening. After fully understanding the risks, they can voluntarily choose whether to carry out prostate cancer screening. If their father or brother suffers from prostate cancer, they can consult a doctor as early as 45 years old.

If you decide to do prostate cancer screening, the main item is blood PSA examination, at the same time do or not do rectal digital examination. PSA is the English abbreviation of prostate specific antigen, PSA of prostate cancer patients is often higher than that of normal people. However, there are many factors that promote PSA elevation, not only prostate cancer, elderly, prostatitis and even long-term cycling may lead to PSA elevation.

Third, endometrial cancer

According to statistics, 52,630 women in the United States suffered from endometrial cancer in 2014, At the same time, 8,590 women died of endometrial cancer. Obesity, diabetes, hypertension, estrogen drugs (such as tamoxifen for breast cancer for a long time) and aging, They are all risk factors for endometrial cancer. However, the early detection of endometrial cancer depends to a large extent on women’s own discovery of abnormal vaginal bleeding, that is to say, endometrial cancer usually appears typical symptoms in the early stage-abnormal vaginal bleeding. As long as timely detection, timely treatment, can obtain satisfactory therapeutic effects.

So what has abnormal vaginal bleeding? For example, postmenopausal vaginal bleeding, such as sudden increase of menstrual volume, such as sudden vaginal bleeding after menstruation, any vaginal bleeding different from normal menstruation, can be regarded as abnormal vaginal bleeding.

Relying on women to find their own symptoms, It does not belong to the category of screening, so it is not necessary to screen ordinary women. For women with high-risk factors, even if there is no abnormal vaginal bleeding, it is also necessary to screen. However, this part of the people are rare, mainly women with a family history of hereditary non-polyposis colon cancer. It is recommended to do endometrial biopsy once a year from the age of 35.

The annual routine physical examination can also detect some cancers early.

The American Cancer Society recommends that adults over the age of 20 need to undergo a routine medical examination once a year. Routine physical examination includes cancer-related physical examination items, Such as thyroid gland, oral cavity, lymph nodes, abdominal physical examination, Specifically, doctors look with their eyes and touch with their hands to judge whether there are abnormalities (such as hard lumps on the thyroid gland and lumps occupying space in the abdomen). However, according to the definition of cancer screening mentioned above, these are not strictly cancer screening, because these tests can also find other diseases and are not specially carried out for cancer.

Especially thyroid cancer. Most thyroid cancer can be detected early. And the treatment effect is mostly good. Many thyroid cancers can be found by doctors’ touch. But the touch itself does not count as cancer screening. Similarly, Although thyroid B-ultrasound and blood tests can find some early thyroid cancers, However, it is not yet recommended for thyroid cancer screening. For some people with a family history of thyroid cancer (and it is also a special pathological type, It is called medullary cancer, which is highly malignant. This thyroid cancer has genetic tendency) and belongs to high-risk groups. Early consultation with a doctor and special genetic tests are required, but this is beyond the scope of cancer screening.

Summary: Changing unhealthy lifestyle is the most reliable way to prevent cancer.

As can be seen from the above, most early screening of cancers requires comprehensive examination and analysis. The so-called “one tube of blood to detect all cancers” is basically a lie. Apart from blood PSA examination, blood tests cannot be used to screen cancer, let alone the significance of blood PSA is still controversial.

It should be noted that cancer screening can only provide clues for early detection of cancer, and cannot finally diagnose cancer. Cancer screening cannot guarantee 100% detection of cancer (false negative), nor can it guarantee that all [abnormalities] are related to cancer (false positive), and the diagnosis of cancer requires more in-depth examination.

Therefore, cancer screening cannot be extended. Instead of relying too much on cancer screening during physical examination, it is better to change your unhealthy lifestyle as early as possible to reduce your risk of cancer. The American Cancer Society recommends the following methods:

1. Stay away from tobacco;

2. Keep the weight within the healthy weight range;

3. Regular physical exercise;

4. Eat more fruits and vegetables;

5. Reduce alcohol intake;

6. Reduce direct ultraviolet radiation on skin;

7. Understand your own physical condition, the physical condition of your family relatives, and your cancer risk;

8. Maintain regular physical examination and reasonable cancer screening.