Alberta Cancer Foundation

Screen Time

When Garth Hampton’s family doctor retired, he quit going for regular checkups. He figured that since he was feeling well, there was really no point. Even when his sister was diagnosed with colorectal cancer, he was confident that it wouldn’t happen to him. “I didn’t visit the doctor after my sister was diagnosed with colorectal cancer, because I figured it wouldn’t happen to me and if it did I’d rather not know about it,” said Hampton. “Looking back on it, it was a foolish way to think.”

After encouragement from his family, Hampton found a new doctor and made an appointment for a checkup. The doctor encouraged him to take a fecal occult blood test (FOBT). The test was abnormal and a follow-up colonoscopy found cancer. Since treatment, Hampton has been cancer free for more than three years and is enjoying spending time with family, fishing, hunting, and playing golf. “This was a close call,” he says. “I didn’t have symptoms and I didn’t think it was necessary to go for regular check-ups. I realize how important it is now. That screening test saved my life.”

Waiting until you’re sick to see a doctor is a little like waiting until you’re in the water before putting on your life jacket. Regular checkups help prevent serious illness by helping you work with your doctor to establish a lifestyle that promotes healthy living. Screening procedures can detect some cancers before the first symptoms appear. In some cases, cancer can be prevented if the procedure reveals precancerous changes. Early detection allows for the use of less invasive treatment protocols and dramatically increases the survival rate for many types of cancer.

“There are many things you should do to maintain a healthy lifestyle including eating well, quitting smoking, maintaining a healthy body weight and being physically active,” says Dr. Huiming Yang, Director of Screening Programs for Alberta Health Services. “Regular preventative check-ups that include routine cancer screening appropriate to your age and sex should also be part of healthy living.”
These basic screening procedures are designed for people at average risk of cancer. Talk to your doctor if a particular type of cancer runs in your family, as you may need to be screened more often or may require different screening tests. Here’s a rundown of the basic recommendations for the four cancers commonly detected during screening.

Breast Tests
Progress has been made in breast cancer survival thanks to improved screening and treatment. Current guidelines suggest that most women under the age of 40 don’t require regular screening mammograms. Physicians should discuss mammography with female patients between the ages of 40 and 49. If a patient chooses to participate in screening mammography, these tests should be performed annually. Women between the ages of 50 and 69 should have a mammogram at least every two years. Women over 69 should consider mammography every two years, taking into account personal health factors and preferences.

Mammography takes place in a specialized screening centre. A mammography technician or technologist asks you to stand close to a mammography machine, positioning your breast and compressing it in the machine to enable the machine to take an image. The test is uncomfortable, but brief. It can identify unusual tissue before you can feel it.

Cervical Checks
Cervical cancer usually develops slowly and Pap screening can detect changes before cancer develops. “It’s estimated that 90 per cent of cervical cancer cases could be prevented by regular screening and follow up care for any abnormalities detected,” says Dr. Laura McDougall, Medical Lead of the Alberta Breast and Cervical Cancer Screening Programs. “Abnormalities can be detected through screening and treated before cancer even develops.”

Alberta’s Cervical Cancer Screening Guidelines advise that women should have Pap tests annually for three years and if all three tests are normal, women can switch to a test every three years. Women should start having tests regularly at age 21 (or three years after becoming sexually active, whichever is later) and continue regular testing at least until age 70.

A Pap test takes place in your doctor’s exam room or clinic. The doctor asks you to undress from the waist down and takes a sample of cells from the inside of your cervix, which are then sent to the lab for testing. It takes minutes and there’s little discomfort.

Colorectal Correction
Colorectal cancer is the second leading cause of cancer-related deaths and the third most commonly diagnosed cancer in Alberta, but many of these cases could be prevented by appropriate screening. Screening procedures vary depending upon your level of risk for this type of cancer – something that can be assessed by your family doctor. For those at an average risk, it’s recommended that a fecal occult blood test (FOBT) be performed every one or two years after they reach the age of 50. This involves collecting a small sample of stool at home and taking it to the lab, where they test it for the presence of blood. If FOBT is positive, colonoscopy is recommended as a follow-up test.

Colonoscopy is sometimes recommended for people who have a parent, sibling or child who has had colon cancer or polyps.

A colonoscopy takes place in the day ward of the hospital. You are lightly sedated and a specialist threads a thin tube into your bowel and examines the inside of the bowel with a tiny camera. He may find a polyp, or protruding bit of flesh in your intestine. Most polyps are benign, but he’ll remove it on the spot, ensuring that it doesn’t get the chance to grow and become cancer. The test is not painful, but you’ll be sleepy and need to rest at home for the balance of the day.

Prostate Pros
There’s no formal screening program in Alberta for prostate cancer, but according to the Clinical Practice Guidelines for Alberta physicians, a Digital Rectal Exam (DRE) and Prostate Specific Antigen testing (PSA) can be used together to make an earlier diagnosis. The guidelines suggest that doctors discuss the risks and benefits of PSA testing with men over 50, men with a higher risk for the development of prostate cancer (family history of the disease or of African Canadian descent), as well as men with an abnormal digital rectal exam (DRE) or lower urinary tract symptoms.

Dr. Huiming Yang, Director of Screening Programs for Alberta Health Services says that the reason there’s no established screening program at this time in Alberta is because evidence is insufficient to determine the benefits of prostate cancer screening. “Medical experts agree that every man needs balanced information on the pros and cons of prostate cancer screening to make an informed decision,” he says. “The decision to use PSA testing for prostate cancer screening should be individual.”