Dec 13, 2013 3 min read

Normally we equate going to the doctor with being sick, but as primary care doctors we focus not only on treating illness, but also on preventing it. This is called preventive medicine. One of the key components to preventive medicine is cancer screening.

We screen patients based on guidelines that come from research data. The guidelines are for the population and may not apply to each individual. It is the primary care physician’s job to provide guidance and help each patient decide which screening they should undergo and when. Cancer screening is available for a small number of cancers: breast, cervical, colon and, to some extent, prostate.

Colon cancer screening is done primarily via colonoscopy, recommended first at age 50 (earlier if you have a strong family history of colon cancer), then usually every 5 to 10 years until age 75, depending on the results of your previous colonoscopy. During colonoscopies, doctors are able to see cancers as well as abnormal growths called polyps, which can be removed before they have a chance of turning cancerous. There are a few other options for colon cancer screening, but none as effective.

Pap smears are recommended for women to detect abnormal cells of the cervix before they become cancerous. As research continues to evolve so do the guidelines, but the current consensus is to screen women ages 21 to 65 every three years with a pap smear (more frequently if the results are abnormal).

The age at which women should start undergoing mammograms for breast cancer screening is up for debate. Some public health boards recommend that otherwise healthy women without a family history of breast cancer start undergoing mammograms at age 50 and repeat screening biannually until age 75. Guidelines from other boards recommend starting at age 40 and continuing annually; their rationale being that cancer in younger women, while less common, is often faster-growing and more likely to be picked up by annual mammography. Which guideline to follow is an individual choice between the physician and patient.

Prostate cancer screening was previously recommended for men ages 50 to 75 via digital rectal exam coupled with a prostate-specific antigen blood test. In 2012, the U.S. Preventive Services Task Force issued a recommendation against prostate cancer screening. This was based on data that screening may cause more harm than good. It was noted that the majority of prostate cancers being detected through screening were likely to be slow-growing and unlikely to spread. Screening may have resulted in surgeries that often cause significant side effects to the male organs without any survival benefit. Despite the changes in guidelines, some men still prefer to undergo screening. Our current practice is to discuss the risks and benefits of prostate cancer screening to help patients make an informed decision.

If you have any concerns about preventive care, contact WHS Primary Care – Lakeside at 724-969-1001.

By Dr. Robert W. Koschik II

WHS Primary Care – Lakeside