Article On Cancer Screening - Why Who and When by Dr. Hombal

CANCER SCREENING: WHY, WHO AND WHEN?
Cancer is a leading cause of death worldwide, accounting for nearly 10 million deaths in 2020, or nearly one in
six deaths. In the Bahamas, cancer is the second leading cause of deaths after Heart disease. One of the effective
ways of controlling this disease is by screening. Screening for Cancer involves testing your body to pick up
Cancer in its early stage when you do not experience any symptoms. Screening tests when done at regular
intervals may detect breast, cervical, and colon cancers early, where treatment is likely to work best. Lung
cancer screening is sometimes recommended for people who are at high risk.
The main goals of cancer screening are to bring down the number of people who die from the disease, prevent
deaths from cancer altogether and to reduce the number of people who develop the disease.
Breast Cancer:
Breast cancer is the most common cause of cancer death in women in the Bahamas. Mammograms are the
mainstay for screening of Breast Cancer. The American College of Radiology recommends annual screening
mammography for women starting at age 40. In cases with high risk like family history or prior exposure to
radiation, you may start screening from age 30 onwards annually.
This affords the maximum benefits of reduced breast cancer deaths, less extensive treatments for cancers
detected, decreased chance of advanced disease, and early treatment of high risk lesions. Having regular
mammograms can lower the risk of dying from breast cancer, thus saving lives!
Colon Cancer:
In both men and women, Colon Cancer is the second leading cause of cancer death in the Bahamas. The goal of
screening for colon cancer is to find the polyps or growths in their early stages, so that they can be removed
before cancer has had a chance to develop. Colon cancer almost always develops from precancerous polyps.
Colonoscopy is the most common screening test where a flexible tube is inserted into the rectum and beyond to
visualize the insides of colon. Virtual colonoscopy (CT Colonography) is a non-invasive alternative imaging test
which uses CT scanner to produce 3D images of the large intestine simulating the colonoscopy. The American
Cancer Society (ACS) recommends that men and women undergo screening for colon cancer beginning at age
50. ACS suggests a regular colonoscopy once every 10 years or a Virtual colonoscopy once every 5 years.
Individuals at increased risk or with a family history of colon cancer may start screening earlier at age 40.
Cervical Cancer:
Cervical cancer is the third most common cause of cancer death in women in the Bahamas. Two screening tests
can help prevent cervical cancer or diagnose it early. The ‘Pap smear’ looks for pre-cancers, the cell changes on
the cervix that might become cervical cancer if they are not treated on time. The HPV test looks for the human
papilloma virus that can cause these cell changes. Although most women with cervical cancer have the HPV
infection, not all women with it will develop cervical cancer.
It is recommended by the Centers for Disease Control and Prevention (CDC) that for women from ages 21
through 29 to be screened with a Pap smear every 3 years. Women with ages 30 through 65 should be
preferably screened every 5 years with Pap and HPV co-testing or continue Pap smear test every 3 years.
Screening with both the Pap smear and the HPV test lowers the number of cases of cervical cancer.
Prostate Cancer:
Prostate cancer is the leading cause of cancer death in Bahamian men. Digital rectal exam and Prostate-specific
antigen (PSA) test are the two methods available for screening. However, screening offers only a small potential
benefit of reducing the chance of death from prostate cancer in some men.
For men aged 55 to 69 years, the decision to undergo periodic prostate-specific antigen (PSA) based screening
should be an individual one. Before deciding whether to be screened, men should have an opportunity to
discuss the potential benefits and harms with their doctor.
Lung Cancer:
The US Preventive Services Task Force recommends yearly lung cancer screening with low-dose computed
tomography (CT scan) for people between 50 and 80 years who have a history of heavy smoking (20 pack-year
or more) and still smoke presently or have quit within the past 15 years. A pack-year is smoking an average of
one pack of cigarettes per day for one year.
To conclude, screening tests can save lives! Talk to your doctor about your personal risk of developing any of
these cancers and the screening plan. Together you can decide on the appropriate screening test and schedule
based on your age, your medical history and your family history. Act now before it is too late!
Dr Amaresh Hombal, MBBS, MD.

Consultant Radiologist
The Imaging and Breast Centers at the Medical Pavilion

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CANCER SCREENING: WHY, WHO AND WHEN?

Dr Amaresh Hombal, MBBS, MD.

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