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Screening Guidelines
The Cancer Committee has identified valuable screening guidelines to assist physicians in ongoing surveillance and patients in early detection of disease.
Guidelines are also available from:
Breast and Cervical Cancer Screening and Treatment
What's available for women in KY who are low-income and without insurance coverage? The Kentucky Cancer Program has produced a Quick Reference Guide for Health Care Providers - Breast and Cervical Cancer Screening and Treatment in Kentucky. The Guide provides an overview of the programs available through the KY Department for Public Health and KY Medicaid Services, along with answers to commonly asked questions including how to make sure patients are referred in time to qualify.
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Breast Cancer Screening Guidelines
The American Cancer Society recommends women 40 and older should have an annual mammogram and an annual clinical breast examination (CBE) by a health care professional and continue to do so for as long as they are in good health. Ideally the CBE should occur before the scheduled mammogram. Women ages 20-39 should have a CBE every three years. Breast self-exam (BSE) is an option for women starting in their 20s.
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Colon and Rectal Cancer Screening Guidelines
Modified from the NCCN, the Kentucky Medical Association has adopted the following screening standards for average-risk patients:
- Colonoscopy every 10 years beginning at age 50
- Yearly fecal occult blood test (FOBT)
- Flexible sigmoidoscopy every five years
For high-risk patients, the Kentucky Medical Association has adopted the following screening standards for high-risk patients:
- Colonoscopy only, beginning 10 years prior to the age of the youngest relative diagnosed
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Prostate Cancer Screening Guidelines
The American Cancer Society recommends that the prostate-specific antigen (PSA) blood test and digital rectal examination (DRE) be offered annually, beginning at age 50, to men who have at least a 10-year life expectancy.
Men at high risk (African-American men and men with a strong family of one or more first-degree relatives (fathers, brothers) diagnosed at an early age) should begin testing at age 45.
Men at even higher risk, due to multiple first-degree relatives affected at an early age, could begin testing at age 40.
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Cervical Cancer Screening Guidelines
The American Cancer Society recommends that all women should begin cervical cancer screening about 3 years after they begin having vaginal intercourse, but no later than when they are 21 years old. Screening should be done every year with the regular Pap test or every 2 years with the liquid-based Pap test.
Beginning at age 30, women who have had 3 normal Pap test results in a row may get screened every 2 to 3 years with either the conventional (regular) or liquid-based Pap test. Women who have certain risk factors such as diethylstilbestrol (DES) exposure before birth, HIV infection, or a weakened immune system due to organ transplant, chemotherapy, or chronic steroid use should continue to be screened annually.
Women 70 years of age or older who have had 3 or more normal Pap tests in a row and no abnormal Pap test results in the last 10 years may choose to stop having cervical cancer screening.
Women who have had a total hysterectomy (removal of the uterus and cervix) may also choose to stop having cervical cancer screening. Women who have had a hysterectomy without removal of the cervix should continue to follow the guidelines above.
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Skin Cancer Screening Guidelines
The American Cancer Society recommends a cancer-related checkup by a physician, including skin examination, every 3 years between ages 20 and 40, and annually for those 40 and older. Everyone should know their own pattern of moles, blemishes, freckles, and other marks on the skin so they can notice changes during monthly self-examinations.
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Lung Cancer Screening Guidelines
The American Cancer Society has concluded that due to lack of symptoms, early detection is difficult. Therefore, there are no recommended screening guidelines for lung cancer at this time.
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