Nurses as Cancer Insurgents: 9 Guidelines for Cancer Screening Tests

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Distinctive tumors were first reported in scientific journals in 1775, and that was scrotal cancer directly associated with chimney sweeps. In 1761, cases of nasal cancer rose among individuals who use snuff or smokeless tobacco. Since then, cancer has made its identity known as the disease that plagues the unsuspecting society.

Cancer can occur anywhere in the body. When the body’s normal control mechanisms become defective, old cells do not die and new abnormal cells continue to proliferate. Consequently, these extra cells form tissue masses which deprive the normal and healthy cells of the nutrients necessary for growth and development.

However, since there is still no cure for cancer, the healthcare industry advocates for prevention and early detection. Screening tests are made to subject persons suspected to have cancer but still do not have the manifestations yet. If the results are highly suggestive, a biopsy is conducted to confirm the working diagnosis.

Mortality Hit Around the World

World Health Organization (WHO) reported that in 2012, there were 14 million new cases of cancer and 8.2 million cancer-related deaths. Sixty percent of these new cases are from Africa, Asia, and some parts of America. In the United States alone, it is estimated that for 2016, there will be 1.6 million new cases of cancer and cancer-related deaths would reach half a million.

Nurses as Cancer Insurgents

When facing cancer, nurses understand the importance of early detection and treatment. This guarantees a relatively higher chance of surviving the savage disease. The problem with cancer is that it only signals its existence when it is already severe. Unlike other diseases, it does not scream pain. Most of the time, before one becomes aware of its existence, cancer has made a map out of one’s body and has lodged itself in every corner.

Nurses have witnessed parents become childless and children become orphaned because of cancer. Therefore, it is important for nurses to spread awareness on cancer and how it can be prevented in the earliest time possible. Nurses should learn cancer screening test guidelines by heart as part of the commitment to saving lives.

Cancer Screening Test Guidelines

Here are the screening test guidelines for different types of cancer according to American Cancer Society and U.S. Preventive Task Force Services:

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1. Breast Cancer

Seventy percent of women have no known predisposing factors to breast cancer but certain risk factors have been established. Risk factors include age 65 and above, two first-degree relatives diagnosed with breast cancer at an early age, high breast tissue density, and factors that affect circulating hormones like late menopause, long-term use of hormonal replacement therapy, and obesity.

Breast cancer screening includes mammography, clinical breast examination (CBE), and breast self-examination (BSE). It is important that patients understand what these examinations are all about, how they are performed, and their limitations.

Mammogram. Image via: Wikipedia.
Mammogram. Image via: Wikipedia.

Mammography (x-ray of the breast) is done yearly for women age 40 and above. However, for women with increased risk, it may be started at age 30. CBE is done every 2-3 years among women 20-39 years of age and then annually after 40 years of age. Basically, this is a physical exam done by a healthcare provider as part of the regular medical check-up. Lastly, nurses should teach women 20 years of age and above on how to perform BSE. This should be done 5-7 days after menstruation when the breasts are not swollen and tender. For women with an irregular sexual cycle, a specific date must be chosen for monthly BSE.

2. Cervical Cancer

Papsmear
Pap Smear

The screening test for cervical cancer is Pap Smear. In 2012, the American College of Obstetricians and Gynecologists (ACOG) released a new guideline for this test. First screening should be at age 21. For women age 21 to 39, screening is done every three years. Until age 60, screening is done with cytology if Pap Smear is positive or if the patient is at high-risk for HPV test. For women who have undergone hysterectomy for benign reasons, routine screening is discontinued. Lastly, for women age 65 and above, routine screening is discontinued if three consecutive Pap smear result is negative.

3. Ovarian Cancer

Currently, there is no effective screening test for ovarian cancer although risk factors would include history of breast or ovarian cancer in the family and mutation in BRCA1 and BRCA2 genes.

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Pelvic exam
Pelvic exam

Pelvic exam is done upon check-up and the doctor would request ultrasound and magnetic resonance imaging (MRI) as needed.

4. Testicular Cancer

Testicular self exam.
Testicular self exam.

Monthly testicular self-examination (TSE) is recommended for men. A painless nodule or lump felt is always advised to be reported to the doctor. TSE should be done after a warm shower so the skin is relaxed.

5. Lung Cancer

Low-dose computer tomography annual screening for lung cancer is recommended for adults age 55-80 years with smoking history of 30 pack years or have quit smoking within 15 years. Screening is discontinued if the person has stopped smoking for at least 15 years.

6. Liver Cancer

American Cancer Society has no current recommendations for liver cancer screening. However, two most commonly requested test for liver cancer includes ultrasound and alpha-fetoprotein (AFP) blood test.

7. Colorectal Cancer

Screening recommendations for colorectal cancer include fecal occult blood test (FOBT), sigmoidoscopy, and colonoscopy.

Colonoscopy
Colonoscopy

Assessment for risk factors (e.g. polyps, first-degree relative with colorectal cancer, personal history of ulcerative colitis, etc.) should begin at age 20. However, for those who are not high risk, routine screening recommendations should take place between 50 and 75 years of age.

FOBT is conducted annually. Another option is to have sigmoidoscopy every five years and FOBT every three years. Third option on the list is to have colonoscopy every 10 years.

8. Prostate Cancer

digital rectal exam

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Prostate cancer is the leading cancer among men in the U.S. and the second leading cause of death. Risk factors include age, history of prostate cancer in the family and African American ethnicity. Screening recommendations include digital rectal examination (DRE) and prostate-specific antigen (PSA). However, these two methods are not highly accurate. DRE can miss as much as 25-35% of tumors and its sensitivity is only 59%. PSA’s detection rate is only 28-35%. It is being recommended to combine the two screening options for men above 50 years of age. For men with risk factors, screening should be started at age 40.

9. Skin Cancer

As of now, there’s not enough evidence to recommend a routine screening that can detect skin cancers early. However, it is important to note that fair-skinned individuals aged 65 and older are at increased risk for melanoma. Having atypical moles and/or more than 50 moles increase the risk of the person for melanoma too.

Pass The Word

How can you help stop cancer from taking away people’s lives? Take these screening guidelines to heart and spread awareness about early detection of different kinds of cancer.

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