reviewing_screenings

No matter what you may have heard about the need for more or fewer cancer screenings, they are so important because they save lives — period.

As director of the Loma Linda University Cancer Center, I highly suggest having a conversation with your primary care doctor about a plan for you. This should include which types of cancer screenings you should have and how often. It will be important for that conversation to include a plan regarding your results. Here’s why.

Some of the confusion in recent years about the need for cancer screenings and their frequency has been the result of some news media stories failing to report the nuances of official recommendations. Also, different organizations have slightly different recommendations for screening. However, it is important to not miss the overall point that cancer screening saves lives and to realize that the minute details of how it is done are probably less important.

The United States Preventative Service Task Force (USPSTF) over the years has continually updated its recommendations on cancer screenings. There are good reasons for these adjustments and readjustments because cancer screening is a complex issue.

The USPSTF is a great public health organization that rates the evidence for screening exams, and it rightly does this so cancer specialists won’t conduct screenings that aren’t useful. It is also important to remember that other organizations, such as the American Cancer Society and the National Comprehensive Cancer Network, also agree with USPSTF that cancer screening saves lives, but they may not agree on every little detail of how to do it.

Years ago, the USPSTF called into question the details of when and how often to screen for some types of cancers — especially breast and prostate. This is because more aggressive screening schedules may detect cancers that are extremely unlikely to develop into anything dangerous. This can cause the patient fear and could require more invasive tests, such as biopsies. It’s rare, but some biopsies can cause complications, such as infections.

This is why I feel it’s important to have this conversation with your doctor prior to the screening process to discuss what you and your doctor would like to do with your results. For, say, an older woman who is not very healthy, a breast cancer screening that shows a tiny, non-dangerous growth that could develop into something dangerous in 30 years, giving treatment now may cause more harm than good. On the other hand, for example, a young healthy male with abnormal prostate screening should absolutely be further tested. 

As you can see, cancer screening is a complex issue involving numerous factors, including age, lifestyle, genetics, and types of screenings and treatments. As medical professionals, we want what’s best for you, your well-being, your quality of life and your overall health. We want you to take appropriate measures to undergo useful screenings, but we don’t want you to undergo unneeded and overly invasive tests that are far more likely to cause concern and harm than is necessary.

I highly suggest having a conversation with your primary care doctor about a cancer screening plan for you. Together you can decide in advance how you would like to handle the results.Mark Reeves, MD, PhD, director of the Loma Linda University Cancer Center

So here are my recommendations. For both genders, I advise getting screened for the most common types of cancers. For women, talk with your doctor about getting screened for breast, lung, colorectal and cervical cancer. For men, talk with your doctor about screenings for prostate, lung and colorectal cancer.

There is strong evidence that the risk of death from these common cancers can be significantly lowered with appropriate screenings.

The compliance rates on some of these screenings are not as high as I and other medical professionals wish they were. 

So please, for the sake of your own health, and for the comfort of your friends and family, have this important conversation with your doctor.

We at Loma Linda University Health want you to live a life as full and healthy as possible.

To make an appointment with a primary care doctor, visit the primary care website or call 909-558-6600.

Mark Reeves, MD, PhD, is director of the Loma Linda University Cancer Center.