March 18, 2024

Doctor group seeks to clear confusion in cancer screening

WASHINGTON (AP) — Mammograms at 40 or 50? Every year or every other year? What’s the best colon check?

Screening for cancer has gotten more complicated in recent years with evolving guidelines that sometimes conflict. Now a doctors’ group aims to ease some confusion — and encourage more discussion of testing’s pros and cons — with what it calls advice on “high-value screening” for five types of tumors.

The American College of Physicians’ advice:

Breast Cancer — The American Cancer Society has long recommended annual mammograms starting at age 40. The U.S. Preventive Services Task Force, which advises the government, says to get mammograms every other year from age 50 to 74, and says starting at age 40 brings little benefit but should be a personal choice if women are told the pros and cons.

Colorectal Cancer — Colonoscopies, which allow doctors to see precancerous growths in the colon, get the most attention. But the ACP advised people ages 50 to 74 to choose from equally good screening choices: a stool test every year; a colonoscopy every 10 years; a sigmoidoscopy, which views the lower colon, every five years; or a combination of a stool test every three years and a sigmoidoscopy every five years.

Cervical Cancer — Screening choices vary by age. The ACP found widespread support for a Pap test every three years starting at age 21. Starting at age 30, women may choose a combination of Pap and a test for the HPV virus that causes cervical cancer — a combination that lets them go five years between tests.

Prostate Cancer — PSA blood tests are highly controversial, with some groups recommending against them and others saying men should get them only after a discussion of the pros and cons. The ACP’s advice: Doctors should tell men ages 50 to 69 about the pros and cons, and order the test for those who then request it.

Ovarian Cancer — The new review found leading medical groups all recommend against blood tests and pelvic or ultrasound exams to screen for ovarian cancer in average-risk women. While this cancer often has spread by the time it’s discovered, there is no proven screening test for it.