Aging & Health A to Z
Diagnosis & Tests
Regular Screening Can Help You Stay Healthy
The American Cancer Society and other groups involved with cancer education recommend regular check-ups and specific tests regardless of how you feel or whether you have any symptoms. This will help find many cancers before symptoms start, while the cancer is small and before it has spread. Early screening often leads to treatment of the cancer and a complete cure.
The screening tests below are recommended for older adults at normal risk who:
- would be interested in pursuing cancer treatment if one were found
- are expected to live long enough to derive benefit from detection and treatment of an early cancer
- are consistent with the person’s overall goals for care.
The age at which various screening tests should be stopped is controversial. This is because there may be a low benefit to screening for cancer or because the screening test itself is burdensome. Most importantly, this decision to screen has to do more with an individual’s overall health and prognosis than his or her age. If you have already been treated for cancer, or have a family history of cancer, talk to your healthcare provider about the need for additional or more frequent tests.
For older women at normal risk, regular screening should consist of:
- mammogram every one to two years
- breast exam by a healthcare professional once a year
- optional monthly breast self-examination.
For older women who have had at least three normal Pap tests in a row, testing is only needed once every three years. If you are over the age of 70 and have had three or more normal tests in a row and no abnormal Pap tests in the previous 10 years, you may stop having Pap tests.
If you have had a total hysterectomy (removal of the uterus and cervix), you don’t need Pap tests any longer, unless you had cervical cancer or pre-cancer. If your cervix was not removed during the hysterectomy, you should continue to have Pap tests.
Screening tests for colorectal cancer may take several forms. Talk with your healthcare professional about which tests are right for you and at what point you should stop screening for colon cancer. For older adults with average risk, the most common types of screening are:
- colonoscopy every 10 years
- flexible sigmoidoscopy every 5 years
- fecal occult blood test (FOBT, a test for blood in your stool) every year.
PSA screening (a blood test) and a digital rectal exam (DRE) are able to detect prostate cancer early, when a complete cure by radiation or surgery is highly likely. But recent research has shown that the benefits of screening may not be worth it in cases of slow-growing, non-spreading disease. This is due to the possible burden from increased anxiety, complications from biopsy (removal of a small tissue sample), or unnecessary surgery with possible permanent side effects. This means it is really difficult to know which men should have screening for prostate cancer and which one the down sides of screening outweigh the benefits.
Men over the age of 50 should discuss the pros and cons of prostate cancer testing. You should consider screening earlier if you are African American or have a father or brother who had prostate cancer before age 65. Men older than 80 years of age are not screened for prostate cancer since the benefit from early detection does not offset the possible harms involved in tests and treatment.
If you have had melanoma, have more than one family member who has had the disease, or have many unusual moles, you should be checked on a regular basis by a dermatologist or trained healthcare professional. Otherwise, routine skin cancer screening is optional.
Cancer of the Uterus (endometrial cancer)
All older women who have reached menopause should report unexpected bleeding or spotting to their healthcare professional. If you are at high risk because of your personal health history, you may need an annual biopsy or ultrasound but most individuals should not have these routinely done.
For many cancers, we unfortunately do not have good tests to screen for them.
If you have been diagnosed with cancer, your healthcare professional or oncologist will order more specific tests. This will help to diagnosis the type of cancer more precisely and aid in identifying the stage or grade of the cancer. That is, how much it has grown and spread. These tests may include some of the following:
- biopsy of the tumor (surgical removal of a small piece of tissue)
- blood tests (which look for chemicals such as tumor markers)
- bone marrow biopsy (if testing for lymphoma or leukemia)
- complete blood count (CBC)
- CT (computed tomography) scan
- MRI (magnetic resonance imaging) scan
- ultrasound studies
- PET (positron emission tomography) scan or combination PET/CT.
Bring someone with you to the oncologist’s office when you are getting your diagnosis. He or she can remind you to ask important questions and help you remember what the oncologist said. It is helpful to write down your questions before your visit, and take notes during your visit, so you can ask additional questions later if there is anything you didn’t understand.
Updated: March 2012
Posted: March 2012