Screening Guidelines

COLORECTAL CANCER SCREENING GUIDELINES

Type of test

High-Sensitivity Fecal Occult Blood Test (FOBT) or  Fecal Immunochemical Test (FIT)

Ask your doctor for a high-sensitivity FOBT or FIT.

The one time FOBT done by the doctor in the doctor’s office is not appropriate.

Note: There are two types of FOBT: one uses  the chemical guaiac to detect blood.  The other—a fecal immunochemical test (FIT)  uses antibodies to detect blood in the stool.  You receive a test kit from your health care provider.

How often you should have it

Beginning at age 50 \once a year

(If anything unusual is found, your doctor will recommend a follow-up colonoscopy.)

Where you can have it done

ANY primary care provider will provide the test kit for you to collect stool sample at home and send the test in to laboratory for testing.


OR


Type of test

Sigmoidoscopy: 

How often you should have it

Beginning at age 50/ Once every 5 years ;with the FOBT or FIT at 3 years

(If anything unusual is found, your doctor will recommend a follow-up colonoscopy.)

Where you can have it done

Danville Gastroenterology Center

501 Rison St, Danville VA 434-791-1152

Internal Medicine Associates

101 Holbrook St, Danville VA 434-792-4041


OR


Type of test

Colonoscopy: An examination of the entire colon with a lighted microscopic tube allows the physician to see any abnormality of the inside of the colon.  Prep is required to cleanse the colon of fecal matter prior to testing and sedation is required.

You can schedule your own! Just have a primary care provider to which the results may be sent!

How often you should have it

50-75, once every 10 years

Considered the GOLD STANDARD for Colorectal cancer screening, removal of suspicious tissue can be removed at the time of exam. 

Where you can have it done

Danville Gastroenterology Center

501 Rison St, Danville VA 434-791-1152

Internal Medicine Associates

101 Holbrook St, Danville VA 434-792-4041

*If you have a family history of colorectal cancer or polyps, you should have the tests beginning at age 40 or 10 years earlier than the age of the youngest family member at time of their diagnosis


BREAST CANCER SCREENING GUIDELINES*

Type of test

Breast self-exam (BSE). The goal is for the woman to be familiar with her breasts so that changes are quickly noticed.  Any changes should be reported to health care provider promptly. 

Changes : lumps, thickness, skin dimpling, irritation, or scaling nipple discharge or pain

How often you should have it

Beginning at 20 years of age, a woman should examine her breast once a month. Just after monthly period when the fluid retention will not interfere with the exam. 

Where you can have it done**

The woman  can perform the exam in the shower or lying down. As long as there is a systematic exam of the breast, a visual inspection, the method is not critically important.

MEN should also perform BSE’s as they can develop breast cancer too!


Type of test

Clinical Breast Exam (CBE): a health care professional examines the breast for any palpable or visible changes.

How often you should have it

Age 20 thru the 39: every 3 years

Age 40 and above: every year close to the time as the mammogram

Where you can have it done**

Every health care providershould be able to perform the CBE. 


Type of test

Mammogram: digital radiological exam is used to visualize changes within the breast

You can schedule your own! Just have a primary care provider to which the results may be sent!

How often you should have it

Age 40 and above: every year. Age alone is not a reason for not having a mammogram, but those with a short life expectancy should have a discussion with their doctor.

Women at hi risk for Breast Cancer should discuss the frequency of mammography as well as genetic testing options

Where you can have it done**

  • Sovah Health - Danville Radiology 799-3883
  • Danville Diagnostic Imaging Center 799-3883
  • Danville Women’s Care 797-7620
  • OB-GYN Associates of Danville 792-7765

Type of test

Ultrasound: not considered standard screening test, but may be used if woman is sensitive to the other screening techniques.

Where you can have it done**

Same as above


Type of test

MRI: may be used for women at hi risk for breast cancer in conjunction with mammography.

Where you can have it done**

Danville Diagnostic Imaging Center 799-3883

*Guidelines according to the American Cancer Society, 2014 http://www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-acs-recs** Mammograms can be arranged the Virginia Department of Health Every Woman’s Life Program  (432-7232) for those women who meet the financial limit and are un- or under-insured.


LUNG CANCER SCREENING GUIDELINES FOR HEAVY SMOKERS*

Type of test

Low dose Spiral CT scan(LDCT): detects lung cancer much earlier and usually pre-symptomatic than the previously recommended annual chest x-ray.

Lung cancer symptoms usually do not occur until the disease is at advanced stage and incurable.

Limitations of LDCT is that it is very sensitive- it picks up abnormalities that may not be cancer, but which must be investigated to rule out early cancer.

LDCT does require specialized equipment and should only be done at facilities that are capable of providing the appropriate follow-up care and testing.

Who should have it and how often

Those who are at the highest risk of developing lung cancer:

HEAVY smokers (2 packs a day for 15 years, 1 pack a day for 30 years)

Age 55-74.  It is thought that early lung cancer in someone older than 74 would not progress enough within the expected life span to cause health issues.

EVERY YEAR

Where you can have it done**

Danville Diagnostic and Imaging Center 799-3883

You can schedule your own! Just have a primary care provider to which the results may be sent!

There are no other recommended screening tests for lung cancer.

Traditional chest xrays are not acceptable forcreening.

*Guidelines according to the American Cancer Society, http://www.cancer.org/cancer/news/new-lung-cancer-screening-guidelines-for-heavy-smokers


PROSTATE CANCER SCREENING GUIDELINES*

Type of test**

The prostate gland is normally a walnut sized structure located around the base of the urethra in men.

Prostate-specific antigen (PSA) is a simple blood test used to detect a protein produced by the prostate gland. 

The prostate produces PSA at low levels in normal conditions and at increased levels in several conditions including inflammation of the prostate (prostatitis) and malignancy.  For this reason, it is recommended that a single increased PSA level not be used as an indicator for cancer.

Digital Rectal Exam (DRE) is recommended as part of annual physical exams for men.  The prostate gland may be palpated by the physician by inserting a finger into the rectum.  Enlargement of the prostate is normal during advanced aging and may cause urinary and sexual function issues in men middle age and older.

Who should have it and how often

At age 50: men should begin discussion with health care provider about the pros and cons of testing with these indicators in mind:

This discussion should begin at age 45 if:

  • African American  (AA males develop prostate cancer about 2x the rate of men of other races.

or

  • A father or brother who has been diagnosed before the age of 65

Each individual man should discuss with his health care provider whether to be tested for prostate cancer. An elevated PSA or enlarged prostate may cause needless and excessive stress and worry for the patient. Further testing involving biopsy and other invasive procedures may not be warranted for a single or even multiple elevated PSA.  Prostate cancer is thought to be slow growing, so men with an expected life left of 10 years or less should not be subjected to further testing.

It is suggested that men with slightly elevated levels take a “watchful waiting” approach with a committed re-test at 6 month intervals or as recommended by the provider.

Where you can have it done**

Any health care provider can draw blood for a PSA and most can perform the digital rectal exam.

Southside Urological Clinic holds a Prostate screening clinic at least once a year.

*Guidelines from:http://www.cancer.org/cancer/prostatecancer/moreinformation/prostatecancerearlydetection/prostate-cancer-early-detection-acs-recommendations

** http://www.cancer.gov/cancertopics/factsheet/Detection/PSA


CERVICAL CANCER SCREENING GUIDELINES*

Type of test

Two types of test are used to test for cervical cancer. Both use cells which have been removed from the cervix during a pelvic exam.

PAP test: detects changes within the cells which indicate cancer.  Capable of detecting very early changes, the PAP is very sensitive.

HPV (human papilloma virus) test: detects the sexually transmitted virus that causes changes in the cells of the cervix which lead to cancer.  The majority of cervical cancers are related to infection with HPV.

Who should have it and how often

Women should begin testing at age 21.

Between the ages of 21 and 29, PAP test should be done 3 years. They should not be tested for HPV unless it is needed after an abnormal Pap test result.

Between the ages of 30 and 65, a PAP and HPV should be done every 5 years.   OR a PAP alone every 3 years.

Over the age of 65,  women who have had regular screenings with normal results do not need to be screened for cervical cancer.   Women who have had pre-cancer results in the past should be continued to be screened.

Women who had hysterectomies with the cervix removed and have no history of cervical cancer or pre-cancer do not need to be screened.

Women who have been vaccinated for HPV should follow the guidelines above for their age group.

Women who are at high risk for cervical cancer should be screened more frequently. (HIV positive, organ transplant, or exposure to the drug DES. They should talk with their doctor or nurse.

Where you can have it done**

Any health care provider who performs pelvic exams should be able to provide the PAP and HIV testing.

*Guidelines from: http://www.cancer.org/cancer/news/new-screening-guidelines-for-cervical-cancer