Executive on Cancer Program for Women

Cancer screening tests are used to detect cancer or pre-cancerous spots before symptoms appear and, in most cases, when treatments are most effective.  Women's cancer screening guidelines have been developed by a number of organizations. While different organizations' standards differ slightly, they all encompass the same basic health screenings for breast, cervical, and colon cancers, and they recommend starting as early as late adolescence.

Additionally, during normal health checkups (at any age), your healthcare professional may check for skin, mouth, and thyroid malignancies. Not every screening test is suitable for everyone. Your personal and family history of cancer, as well as the presence of a known genetic susceptibility, can influence which tests are appropriate for you and when you should start them. As a result, you should talk with your healthcare physician about them.

Pap Smear

A Pap smear (or Pap test) is a painless, rapid technique for detecting cervical cancer. It entails employing a microscope to look at cells obtained from the cervix. The test screens for abnormal cervical alterations (cervical dysplasia), and precancerous or cancerous cells that could signal malignancy. If any are detected, more testing, like colposcopy or biopsy, will be performed to determine whether cancer is present.

George Papanicolaou, a Greek doctor who developed the test in the early 1940s, is the test's name.

What is Pap Smear?

A Pap smear is used to detect abnormal cervical alterations that could indicate the development of cancer or the presence of malignancy. 

Many times, it is possible to detect and remove growing cancer before it spreads beyond the cervix. Pap smears are commonly performed as part of routine pelvic exams.

Cells obtained during a Pap smear are also examined for high-risk strains of the human papillomavirus (HPV), which can cause a variety of malignancies, in certain women. The virus has over 100 strains, but not all of them cause infection. HPV 16 and HPV 18 are responsible for about 70% of cervical cancers, while HPV 31, 33, 34, and 52 infection is responsible for 20% of cervical cancers.

Who Can Get Pap Smear?

Because the Pap is a screening test, there are particular recommendations for who should have it, when they should have it, and how often they should have it based on age and risk factors. The American College of Obstetricians and Gynecologists (ACOG) has issued new guidelines for cervical cancer and HPV screening:

• Every three years, women aged 21 to 29 should get a Pap test alone (but should not be checked for HPV).
• Every five years, women aged 30 to 65 should receive a Pap test and an HPV test (known as co-testing). Although ACOG favors the five-year co-testing plan, a Pap test every three years is equally acceptable.

If a woman has had three negative Pap smears in a row or two negative co-test findings in a row within the past 10 years, with the most recent test taken within the last five years, ACOG says she can safely stop having Pap smears after age 65 if she does not have a history of moderate - to - severe abnormal cervical cells or cervical cancer.

Although these recommendations apply to all women, specific risk factors for cervical cancer may indicate that more frequent Pap smears are necessary. Among them are:

• Cervical cancer running in the family
• A cervical cancer diagnosis or a Pap smear that revealed precancerous cells
• Human immunodeficiency virus (HIV) infection
• Many reasons, such as organ transplantation, chemotherapy, or corticosteroids (weakened the immune system).
• Sexual activity begins early in life (intercourse)
• Having several sexual partners
• Genital herpes or chlamydia (sexually transmitted infections).
• Previously diagnosed genital cancer
• Smoking
• Prenatal exposure to diethylstilbestrol (DES). DES was often used to reduce miscarriages until studies revealed that women born to moms who took DES had an elevated risk of cancer. The United States Food and Drug Administration (FDA) urged doctors not to prescribe it during pregnancy in the 1970s.

Even if you've had a hysterectomy, you may still need Pap tests. This is dependent on the reason for your hysterectomy, whether your cervix was removed (because cervical cells can remain at the top of the vagina after the surgical procedure), and whether you have a past history of moderate - to - severe cervical changes or cervical cancer, in which case you should have Pap smears for the next 20 years.

Pap Smear Results

The results of a Pap test normally take one to three weeks, per the Office on Women's Health of the United States Department of Health and Human Services.

Positive results indicate the presence of aberrant cells, while negative results indicate the absence of cervical abnormalities.

Many medical offices send out negative (normal) results through mail. Positive (abnormal) results are usually reported by phone. If the findings are normal, some companies will not contact you at all. If you're not sure what the office's policy is on this, phone and inquire. Make no mistake: no news is good news.

It's crucial to understand that an abnormal Pap test doesn't automatically imply malignancy. Remember that this is a screening technique, not a diagnosis. The majority of abnormal Pap smears are not related to malignancy.

Abdominal Ultrasound

Ultrasound (also known as ultrasonography, sonography, or sonogram) is a diagnostic tool that allows doctors to examine for tumors in places of the body that aren't visible on x-rays. This approach is frequently used by doctors to guide a needle during a biopsy. Most ultrasounds are short and don't require any extra preparation. They're frequently performed on an outpatient basis.

By sending high-frequency sound waves through your body, an ultrasound machine makes images called sonograms. Echoes are created when sound waves bounce off organs and tissues. These echoes are converted into real-time images that depict organ shape and movement, as well as blood flow through blood vessels, by the device. On a computer screen, the images can be seen.

Ultrasound is excellent in capturing images of soft tissue problems that aren't visible on x-rays. Fluid-filled cysts and solid tumors have extremely different echo patterns; therefore, ultrasound can help distinguish them. It's useful in some cases since it may be completed fast and without exposing people to radiation.

The images produced by ultrasound aren’t as detailed as those produced by CT or MRI scans. Ultrasound can't determine if a tumor is cancerous or not. Its application is also limited in some areas of the body since sound waves cannot pass through air (such as the lungs) or bone.

Ultrasound is frequently used to guide a needle during a biopsy (taking out fluid or small pieces of tissue to be examined under a microscope). While pushing the needle, the doctor watches the needle move closer and into the tumor on the ultrasound display.

The transducer (the probe that puts out sound waves and picks up echoes) is placed against and moved across the skin surface for some types of ultrasound examinations. The sound waves go through the skin to the organs below. In other circumstances, the doctor must insert a transducer into a body opening such as the esophagus (the tube linking the throat and the stomach), rectum, or vagina to obtain the best images.

Doppler flow devices are ultrasound devices that can demonstrate how fast and in which direction blood flows through blood vessels. This is advantageous because tumor blood flow differs from that of normal tissue. Color images are produced by several of these devices. Doctors can now use Color Doppler to see if cancer has spread to blood vessels, notably in the liver and pancreas.

Gastroscopy

Upper endoscopy, also referred to as gastroscopy, involves examining the upper digestive tract using a thin flexible tube (endoscope).

To observe these places, the tube is placed into the mouth and proceeds down the food pipe (esophagus), stomach, and first portion of the small intestine (duodenum).

The endoscope has a lamp and video camera that sends images to a monitor where a doctor can see them.

Symptoms like dyspepsia, sickness, or difficulty swallowing are frequently evaluated with a gastroscopy. It can reveal inflammation, ulceration, a polyp, or another abnormality.

Gastroscopy is sometimes used to treat diseases like bleeding peptic ulcers, widening a narrow esophagus (known as dilatation), or removing a foreign object. Doctors can obtain tissue samples (biopsies) and remove polyps from anything abnormal they detect.

Colonoscopy

A colonoscope, which is a long, flexible tube approximately the width of a finger with a light and small video camera on the end, is used by a doctor to examine the inside of the colon and rectum. It is inserted through the anus, rectum, and colon. If necessary, special devices can be introduced through the colonoscope to biopsy (sample) or excise suspicious-looking spots like polyps.

Colorectal cancer can be detected using this test. Screening is used to detect cancer in patients who have no symptoms. During the colonoscopy, any suspicious spots can be collected (biopsied) and screened for malignancy. To collect the samples, long, thin tools such as little forceps (tweezers) are sent down the colonoscope. A screening colonoscopy can also help prevent colon cancer by detecting and eliminating polyps (inner lining growths) before they become cancerous.

Colonoscopy can also be done to check for new tumors if you've had colon or rectal cancer. Colonoscopy can also be done to rule out colon or rectal cancer as the origin of signs or symptoms (such as altered bowel movements, bleeding from the rectum, or unexplained weight loss).

Some disorders in the colon or rectum can be treated by a colonoscopy. A colonoscope, for example, can be used to remove polyps or other tiny tumors (growths) in the colon or rectum.

A colonoscopy can be used to implant a hard tube called a stent into a portion of the colon or rectum to help keep it open for some advanced malignancies that can't be removed (because they're too big or have spread).

Abdominal Pelvis CT

CT scanning, often known as CAT scanning, is a painless, non-invasive diagnostic procedure that aids physicians in diagnosing and treating medical disorders. CT imaging uses a computer to put together numerous images of the inside of the body into cross-sectional and 2D/3D representations of the area being examined. After that, the photos can be seen on a computer monitor or printed. CT scans of internal organs, bones, soft tissue, and blood vessels are more detailed than traditional x-rays.

This method is commonly used to determine the source of abdominal pain and bowel and colon disorders, such as:

• Colon, liver, pancreatic, and kidney cancers
• Lymphoma
• Cancer diagnosis and staging

CT scans of the abdomen and pelvis are also used to:

• Examine the liver, spleen, pancreas, and kidneys.
• Plan and administer radiation treatments for cancers correctly.
• Biopsies using a guide and other minimally invasive techniques
• CT imaging is also useful for detecting, diagnosing, and treating vascular problems that can lead to stroke, gangrene, or renal failure.

Chest X-ray

Although no published evidence exists to back this up, the chest radiograph (also known as a chest x-ray or CXR) is regarded to be the most commonly conducted radiological investigation worldwide. The chest radiograph stays the most often requested imaging test by doctors in England and Wales, according to UK government statistics.

A chest radiograph can be used for a variety of reasons, including but not limited to:

• Respiratory disease
• Hemoptysis
• Pneumothorax
• Metastasis is suspected
• Follow-up on a known disease to see how it's progressing
• Persistent breathlessness
• Pneumoperitoneum and pneumomediastinum
• Assessment of symptoms that could be related to the abdominopelvic disease.
• Monitor patients in intensive care units.
• Imaging following surgery.

Low-Dose Chest CT

Screening tests assist your doctor in detecting an issue before you have symptoms. Lung cancer screening is a means to detect some lung cancers earlier, when there is a better chance of a cure and the cancer is more manageable.

A low-dose CT scan of your chest will be performed if your doctor requests lung cancer screening. A spiral CT scanner makes circular rotations around your body. This doughnut-shaped equipment creates detailed images by sending low-dose X-rays, or radiation, through your chest. A low-dose CT scan emits significantly less radiation than a standard CT scan. A doctor will evaluate images of your lungs for nodules, which could be cancerous growths.

The majority of people do not require regular lung cancer screening. It's just for adults aged 55 to 74 who are or were daily smokers with at least 30 pack-years of the smoking habit. Doctors use a pack-year to determine how much you've smoked.

To calculate your pack-years, multiply the number of packs you smoke every day (assuming 20 cigarettes per pack) by the number of years you've been smoking.

If you have the following symptoms, your doctor may suggest that you get screened every year:

• Your age is between 55 and 75 years.
• You also have at least 30 pack-years of smoking habits.
• You've been smoking for at least 15 years or have recently quit.

Pulmonary Function Tests (PFTs)

Pulmonary function tests (PFTs) are noninvasive diagnostics that determine how effectively the lungs are functioning. Lung volume, lung capacity, flow rates, and gas exchange are all determined by these tests. This test is used to diagnose asthma and chronic obstructive pulmonary disease (COPD). This information can help your healthcare professional in diagnosing and treating some lung conditions.

Pulmonary function tests (PFTs) are performed for a variety of reasons. They are sometimes performed as part of a standard physical examination in healthy adults. They're also done on a regular basis in some types of workplaces to ensure workers’ health (such as in graphite factories and coal mines). PFTs may also be used if your healthcare professional requires assistance in diagnosing a health concern, such as:

• Allergies
• Respiratory infections
• Breathing problems caused by a chest injury or recent surgery
• Asbestosis. Inhaling asbestos fibers causes asbestosis.
• Scoliosis, cancers, or inflammation or scarring of the lungs.
• Sarcoidosis is an inflammatory cell disease that produces masses around organs like the liver, lungs, and spleen.
• Scleroderma is a disease that causes connective tissue to thicken and stiffen.

PFTs can be used to monitor lung function in patients with lung or heart difficulties, smokers, or other health issues before surgery or other operations. PFTs are also used to evaluate treatment for asthma, emphysema, and other chronic lung diseases. PFTs may be recommended for other concerns by your healthcare professional.

Thyroid Ultrasound

The thyroid gland is examined using sound waves in a safe and painless practice named a thyroid ultrasound. It can be used to diagnose a variety of thyroid-related medical disorders, including benign thyroid nodules and potential thyroid malignancies.

Thyroid ultrasound can be used by doctors to assess a variety of medical disorders that affect the thyroid gland, an endocrine gland in the neck. Many important physiological processes are influenced by thyroid hormones, including heart rate, body temperature, and body metabolism.

The scan may be performed as part of a general medical examination, particularly if you have symptoms that are compatible with thyroid disease, such as fatigue. Some patients have a thyroid ultrasound because they have a tiny lump in the area. If the findings of other tests, such as a thyroid function test, are abnormal, you may be offered the test.

Thyroid ultrasounds are sometimes used for screening. Regular thyroid ultrasounds may be required if you have a higher risk of thyroid cancer (for example, due to certain genetic conditions). This could also be the case if you've received radiotherapy on that area of your body before. If you've already had a thyroid cancer treated, a thyroid ultrasound can be used to check the area for tumor recurrence.

Breast Ultrasound

Breast ultrasound creates computer images of the inside of the breast using sound waves and their echoes. It can reveal certain breast alterations that are difficult to detect on mammograms, such as fluid-filled cysts.

Ultrasound is not commonly used as a regular breast cancer screening test. However, it can be helpful in detecting some breast changes, such as lumps (particularly those that can be felt but not seen on a mammogram). Ultrasound is especially useful for women with dense breast tissue, which makes abnormal spots on mammograms difficult to see. It can also be utilized to have a closer look at a questionable area discovered on a mammogram.

Ultrasound is helpful because it may distinguish between fluid-filled lumps like cysts (which are probably to be malignancy) and solid masses (which may require additional testing to ensure they aren't malignant tumors).

Ultrasound can also be used to direct a biopsy needle into a breast area, enabling cells to be removed and screened for malignancy. Swollen lymph nodes under the arm can also be treated this way.

Ultrasound is widely available and relatively simple to obtain, and it does not expose the patient to radiation. It is also less expensive than other testing methods.

Mammograms, breast ultrasounds, and breast MRI data are all described using the same standard approach. This approach, known as BI-RADS (Breast Imaging Reporting and Data System), divides the results into six categories.

Doctors can describe what they see on an ultrasound using the same phrases and terms by classifying the results into these categories. This simplifies the process of conveying test findings and following up after the testing.

Breast Mammogram

An X-ray examination of the breast is known as mammography. It is used to identify and diagnose breast disease in both women with and without breast symptoms, such as a lump, discomfort, or nipple discharge. Breast malignancies, benign tumors, and cysts can all be discovered with this approach before they become palpated (touch).

Although mammography cannot confirm that an atypical spot is cancer, if it raises a strong suspicion, the tissue will be taken for biopsy. To determine if tissue is cancer, it can be removed with a needle or an open surgical biopsy and studied under a microscope.

Mammography has been used for about 30 years, and technological developments have substantially enhanced both the process and the outcomes in the last 15 years. Today, specialized technology used specifically for breast X-rays offers high-quality examinations with little radiation exposure. Radiation hazards are regarded as insignificant.

Mammography can be used to detect cancer or to diagnose it. If you have signs like a palpable lump, thickening or depression of the breast skin, nipple discharge or retraction, erosive sore of the nipple, or breast pain, you should get a diagnostic mammogram.

When physical assessment and history are inconclusive, mammography may be utilized to diagnose breast pain. Mammography may be used to screen women with dense, lumpy, and/or very large breasts, as physical assessment may be challenging.

Mammography may be used to screen women who are at higher risk for breast cancer or have a history of breast cancer. There could be other reasons why your doctor suggests a mammogram.

Conclusion

Even if you are in good health, you should see your doctor for regular checkups. These visits may help you avoiding future issues. The only way to know if you have occult undiagnosed cancer, for example, is to have it examined on a regular basis. In the early stages, various types of body cancer may not cause any symptoms. These problems can be checked with a simple screening test.