Cancer screen

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Thyroid Cancer

in development

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Cervical Cancer

  • Female age 21 to 29, Pap smear every 3 years
  • Female age 30 to 65, Either pap smear every 3 years or hrHPV test every 5 years; recommend co-testing (pap smear plus hrHPV) screening every 5 years
  • Female older than 65, no routine screening for a history of 3 consecutive times of negative pap smear or 2 consecutive times of negative co-testing 

Share the big news

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Breast Cancer

  • Female age 40 to 74
  • Methods: digital mammogram every 2 years; or digital mammogram every 1 year for an individual with high risks
  • Why: early detection can decrease mortality: 90 % survival rate in stage I breast cancer while a 10% survival rate in stage IV breast cancer
  • Genetic testing (BRCA 1/2): People with a family history of cervical cancer, breast cancer or BRCA related cancer will require risk assessment by using screening stool (B-RST, FHS-7); High-risk people require BRCA 1/2 genetic testing
  • Early and frequent screening for people with positive BRCA 1/2, or medication prevention, as well as prophylactic surgery

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Lung Cancer

  • Age 55 to 80 years with a heavy smoking history (20 pack-year)
  • Low dose CT chest annually
  • Why: Lung cancer is the 3rd common cancer but the highest mortality in the US. The study shows a 5-year survival rate for stage I NSCLC close to 65% but only 10-15% for stage III to stage IV NSCLC
  • Prevention: Stop smoking!

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Liver Cancer

  • Recommend abdominal sonogram every 6 months for liver cirrhosis patients; Abdominal sonogram every 3 months for nodules over 1 cm
  • Four-phase CT of abdomen correlate with a clinical presentation for liver cancer diagnosis
  • Liver cancer treatment options: Surgery-liver resection! Not just for solitary HCC but also for other cancer type metastasize to the liver. Other options include Radiofrequency ablation, Microwave ablation, Transarterial chemoembolization, Transarterial radioembolization, Percutaneous ethanol injection, External beam radiation therapy or target therapy with Sorafenib
  • Prognosis: the 5-year survival rate of 40-70% in early-stage liver cancer

Prevention: Hepatitis B vaccination, ETOH and smoking cessation, lifestyle modification, prompt treatment for hepatitis C

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Gastric cancer

In development

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Colon Cancer

  • Age above 45
  • Age 40 for positive family history of colorectal cancer or 10 years earlier than the age of onset from the first-degree generation
  • Methods: Colonoscopy every 10 years (Invasive)

                                Cologuard every 3 years (non-invasive)

                                Guiac test every year (non-invasive)

  • Recommend Colonoscopy for positive Guiac test or Cologuard test

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Prostate Cancer

  • Objects: people age 55 to 80 years
  • Methods: check PSA every 2 to 4 years, normal range: 2.5-4 ng/mL
  • Risk factors: age, ethics (Black), family history of prostate cancer, tobacco, a diet high in red meat and animal fat, and low in vegetables
  • Conditions for false-positive PSA: urinary tract infection, high intense activity, sexual activity, and certain medications

Other screening

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Osteoporosis

  • Age above 65 or below 65 with risk factors
  • Risk factors: low BMI (<19), alcohol, tobacco, long-term oral or injectable steroid, history of fracture, history of fall in the last year
  • Screening tool: Fracture Risk Assessment Tool (FRAX)
  • Method: DEXA scan

                              Central DEXA scan: performed on the lower spine and hip

                              Peripheral DEXA scan: performed around the ankle

  • Why women: The condition of osteoporosis is 4 times in women than men.
  • Male: above 70 or 50-69 with risk factors per NOF
  • Prevention: weight-bearing exercise, muscle-strengthening exercise, Yoga, Pilates
  • When to start treatment: 10-year risk of hip fracture higher than 3% or 10-year risk of a major osteoporosis-related fracture higher than 20% per FRAX

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HCV

  • WHO goal, elimination of HCV infection by 2030
  • The overall US prevalence rate for HCV infection is estimated to be 1%
  • Universal HCV screening at least once in all adults and during each pregnancy
  • Direct-acting antivirals are approved by the FDA for children aged 3 years or older

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HIV

  • Age 13-65 or individuals with high risks
  • Pregnant persons
  • Blood testing