A CLEAN BILL OF HEALTH

World Cancer Day – What to Know about Cancer Screening and Treatment Options

Cancer screening helps to detect cancers early, when you may not have any symptoms. The reason why it is important is because early detection and treatment of cancers result in better outcomes. In addition, pre-cancerous conditions may also be detected, and if treated, can prevent the development to cancer.

Men and women are recommended to be screened for the common cancers like colorectal cancer, while women should be screened for cervical cancer if they are sexually active, as well as for breast cancer from 40 years of age. At age 30, women should start to perform Breast SelfExamination (BSE), which can help detect changes in their breasts.

Depending on your risk factors, screening for other types of cancers is also recommended. These include lung cancer for ex-smokers, stomach cancer, liver cancer and prostate cancer.

PRINCIPLES FOR CANCER SCREENING

The World Health Organisation (WHO) recommends that screening should follow specific principles:

Screening should be done only for an important heath problem of serious consequence;
The screening test must be reliable enough and not cause harm; and
There must be an acceptable and effective treatment for the disease when detected at an early stage.

TESTS FOR DIFFERENT CANCERS

While there are established tests like the mammogram, Pap smear and colonoscopy which are supported by scientific evidence, there are also many other tests which, when done, can lead to considerable physical and psychological harm to those tested. Hence, it is important to speak to a trusted physician to discuss on the types of screening that are suitable, before going ahead with the tests.

COLORECTAL CANCER SCREENING

Colorectal Cancer Screening can be performed with a stool test or a colonoscopy.

A stool test looks at a sample of your stool (faeces) to check for blood. Blood in the stool means there is possibly bleeding in the digestive tract and this may be caused by different conditions, including polyps, haemorrhoids, diverticulosis, ulcers, inflammation of the intestines and colorectal cancer. If blood is detected in your stool, your doctor may advise you on the need for a colonoscopy. Not all colorectal cancers cause bleeding, hence a negative stool test does not mean you do not have cancer.

A more sensitive test would be a colonoscopy. This is a test to check the lining of the lower digestive tract i.e., the colon and rectum. Individuals with a family history or anyone above 45 years of age are encouraged to be screened for colorectal cancer as it is the most common cancer in Singapore.

BREAST CANCER SCREENING

Breast Cancer Screening involves a mammogram and occasionally, an ultrasound scan.

A mammogram is a low-dose x-ray of the breast and is used to detect breast cancers. An ultrasound uses sound waves to produce pictures of the internal structures of the breast. It is mainly used to help identify breast lumps or other abnormalities which you may have found during a physical check, or during a mammogram.

A mammogram looks for early signs of breast cancer. It is recommended for females between the age of 40-50 years old to undergo these tests every year, and for older females to undergo the tests every two years. If picked up early, breast cancer can be treated well and cured.

CERVICAL CANCER SCREENING

Cervical Cancer Screening involves a Pap smear test, and a test to detect the human papillomavirus virus (HPV). The goal of screening for cervical cancer is to find precancerous cervical cell changes, where treatment can prevent cervical cancer from developing. The HPV/Pap test uses an HPV test and Pap test together to check for both high-risk HPV and cervical cell changes. If detected, patients will be advised to see a specialist who will advise further treatment.

Contributors:

Dr Grace Tan

Senior Consultant,

Melissa Teo Surgery

The Surgical Oncology Clinic

MBBS(London), MMED (Surgery), FRCS (Edinburgh)

Prof Melissa Teo

Senior Consultant

Melissa Teo Surgery

The Surgical Oncology Clinic

MBBS, MMED (Surgery) FRCSED, FAMS, MPH