The SCREENING Issue

The question you should be asking

The SCREENING Issue

We spend so much of our days surrounded by screens: tv screens, phone screens, computer screen, and even movie screens. But there is one screen… rather, screening that we don’t often think about.

Have you ever wondered about cancer screening? Should you be getting some sort of cancer screening?

Short answer: YES

If you are a human being, regardless of how well and healthy you believe you are living your life, you are still at risk for cancer. As doomsday as it sounds, truly, no one is 100% immune to the risk of cancer. Cancer screening is not simply a health issue, it’s a lifestyle issue that should be ingrained into our quest to live better.

Screening guidelines can get quite confusing because guidelines and recommendations are always changing. The truth is, they should change and evolve as we learn more information, so the fluctuation in recommendations is not necessarily a bad thing. So how can you make sure you’re up to date? My recommendation to everyone is this: whenever you go in for your annual physical with your GP / PCP, always ask them if you are up to date on your age appropriate cancer screens. They will expect this question and should be able to guide you appropriately. They’ll likely talk to you about mammography, colonoscopy, CT scan of the lungs, Pap smears, PSA levels etc. and give you the general timeline for screening.

But there’s another question I want you to ask them, the question you’re probably not asking: “am I up to date on my race appropriate cancer screening”? They might find this one a bit more challenging.

Most of us know it inherently, but in case you don’t, the fact remains that disparities in healthcare permeate all avenues, including disease prevention, cancer screening, diagnosis, and treatment. Ethnic minorities generally do far worse than Caucasians in most aspect of the cancer paradigm. Many factors contribute to this, including access (money, insurance, location) to healthcare and preventive care, health care education and literacy, cultural beliefs, mistrust of the medical field (think HeLa cells and the Tuskegee syphilis experiment amongst others), and prejudice.

In the United States, most healthcare providers default to the screening recommendations put forth by the U.S. Preventive Services Task Force (USPSFT), who provide a broad range of recommendation that take into account the evidence available, the cost, and much more. Unfortunately, the USPSTF guidelines do not (yet) take race into consideration in the same way it does age. Medical societies though have been changing their guidelines due to more and more data showing the difference in cancer incidence and stage at diagnosis among members of different races.

This is where things get confusing. For example, USPSFT recommends biennial screening mammography for women aged 50 to 74 years, stating that the decision to screen earlier is a personal choice and should be weighed against the number of potential false-positive results that will lead to unnecessary biopsies. This is definitely something to keep in mind, unless you are African American. In fact, the American College of Radiology and The American Cancer Society now recommend that African American women initiate annual breast cancer screening earlier, at age 45. The reason for this is that although the incidence of breast cancer is similar among non-Hispanic white women and African American women, African American women are 42% more likely to die from breast cancer, they are more likely to be diagnosed at a higher stage of the disease, they are more likely to have triple negative breast cancer (very aggressive), and are at a higher risk of having the BRCA1 and BRCA2 genetic mutations compared to women of Western European ancestry. There are similar findings in prostate cancer and colon cancer.

The bottom line: Genetics and the health pattens seen in groups matter…

… and it should matter to your physician as well.

Don’t walk out of your next physical without asking your doctor if you are up to date on both your age and race appropriate cancer screening recommendations. It could make all the difference in your world.

#LTIL