Cancer Screening Diagnosis -

Cancer screening diagnosis

“Cancer screening”, you must have heard this term at least once in your lifetime. Do you know what cancer screening is? How is it done for different forms of cancers? What about the benefits or risks? These are a few questions that people usually ask us. In this article we discuss what cancer screening is and why it’s important for you.

What is cancer screening?

Cancer screening is a test that looks for early signs of cancer in people without symptoms. It can help us in detecting cancer at any early stage where the treatment is more likely to be successful and easy when compared to people who have cancer at later or advanced stages.

Why is cancer screening beneficial for you?

● Screening can detect cancer at an early stage. If cancer is picked up early, it means that treatment is more likely to work and more people survive.
● Cervical screening can detect abnormal changes before they can turn into cancer. Treating these early changes can prevent cancer from developing in the first place.
● Reduce deaths

Are there any risks to screening?

Yes, cancer screening is beneficial. But, it also has slight risks like:

● False positives. Sometimes a screening test will suggest that a person has cancer when they do not.
● Increased testing. Doctors may run additional tests that a person may not need because of over diagnosis and false positives. These tests can be physically invasive, costly and can cause unnecessary stress and worry. Some screening procedures can cause bleeding or other problems. For example, colon cancer screening with sigmoidoscopy or colonoscopy can cause tears in the lining of the colon.
● False reassurance. Sometimes a screening test will suggest a person does not have cancer when they actually do. As a result, a person may not get the treatment he or she needs.

What are the different screening tests available?

Self-screening, Physical Examination and History: An examination of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual.
Laboratory Tests: Medical procedures that test samples of tissue, blood, urine, or other substances in the body.
Imaging Procedures: Procedures that take pictures of areas inside the body.
Genetic Tests: A laboratory test in which cells or tissue are analyzed to look for changes in genes or chromosomes. These changes may be a sign that a person has or is at risk of having a specific disease or condition.

Remember that screening tests usually do not diagnose cancer. If a screening test result is abnormal, more tests may be done to check for cancer. For example, a screening mammogram may find a lump in the breast. A lump may be cancer or something else. More tests need to be done to find out if the lump is cancerous. These are called diagnostic tests. Diagnostic tests may include a biopsy, in which cells or tissues are removed so a pathologist can check them under a microscope for signs of cancer.

Do you need to be screened?

Do you have the risk factors that might lead to development of cancer in the future? Then yes, it’s better to keep an eye on your body. Anything that increases the chance of cancer is called a cancer risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer either.

Some screening tests are used only for people who have known risk factors for certain types of cancer. People known to have a higher risk of cancer than others include those who have any of the following:

● A personal history of cancer.
● A family history of cancer.
● Certain gene mutations (changes) that have been linked to cancer.
● Exposure to cancer-causing agents such as tobacco smoke or workplace chemicals.
● A blood clot that develops for no known reason.
● Older age.

People who have a high risk of cancer may need to be screened more often or at an earlier age than other people.

Let’s have a look at screening for a few types of cancers

1.Screening for Lung Cancer: is one of the most common forms of cancers in the world. If lung cancer is found at an earlier stage, when it’s small in size and before it has spread, it’s more likely to have a successful treatment outcome.

Usually symptoms of lung cancer do not appear until the disease is already at an advanced stage. Even when lung cancer does cause symptoms, many people may mistake them for other problems, such as an infection or long-term effects from smoking. This may delay the diagnosis. Current and former smokers are at a higher risk of getting lung cancer.

The only recommended screening test for lung cancer is low-dose computed tomography (also called a low-dose CT scan, or LDCT). During an LDCT scan, you lie on a table and an X-ray machine uses a low dose (amount) of radiation to make detailed images of your lungs.

You can go for yearly lung cancer screening with LDCT for people who:

● Have a 20 pack-year or more smoking history
● Smoke now or have quit within the past 15 years
● Are between 50 and 80 years old

A pack-year is smoking an average of one pack of cigarettes per day for one year. For example, a person could have a 20 pack-year history by smoking one pack a day for 20 years or two packs a day for 10 years.

2.Screening for Melanoma: Recognizing the early warning signs of skin cancer and doing regular self-examinations of your skin can help find skin cancer early, when the disease is more likely to be cured.

Self-examinations should be performed in front of a full-length mirror in a brightly lit room. It helps to have another person check the scalp and back of the neck. For people with fair skin, non-melanoma skin cancer most often begins in places that are frequently exposed to the sun. For people with darker skin, squamous cell carcinoma often occurs in areas that are not as frequently exposed to the sun, such as the lower legs.

Include the following steps in skin self-examination:

● Examine the front and back of the entire body in a mirror, then the right and left sides, with arms raised.
● Bend the elbows and look carefully at the outer and inner forearms, upper arms (especially the hard-to-see back portion) and hands.
● Look at the front, side and back of the legs and feet, including the soles and the spaces between the toes.
● Part the hair to lift it and examine the back of the neck and scalp with a hand mirror.
● Check the back, genital area and buttocks with a hand mirror.

Talk with your doctor if your hairdresser or barber has noticed a suspicious lesion on your scalp or under your beard, or if you find any of the following during self-examination:

● New growth on the skin
● A suspicious change in an existing mole or spot
● A sore that does not heal within 2 weeks

3.Non-Hodgkin’s Lymphoma- The best way to find Lymphoma early is to pay attention to possible signs and symptoms. One of the most common symptoms is enlargement of one or more lymph nodes, causing a lump or bump under the skin which is usually not painful. This is most often on the side of the neck, in the armpit, or in the groin.

● Blood Tests
A blood test measures and counts the different types of cells in the blood. A complete blood count, also called a CBC, lets the medical experts check for:

● The number of red blood cells and platelets
● The number and type of white blood cells

● Blood Chemistry Studies

These tests measure the function of the liver and kidneys and will determine what type and how much chemotherapy a patient can safely receive.
● Imaging Tests

Diagnostic medical imaging exams might include the following:

● Computed Tomography (CT) Scanning

Use X-rays to capture cross-sectional images of the lymph nodes. Patients may need to have a dye injected into a vein to help highlight certain organs or tissues.

● Magnetic Resonance Imaging (MRI) Scans

Use powerful magnets to capture high-resolution images. MRIs can show excellent detail of certain areas inside the body, especially soft tissues.

● Positron Emission Tomography (PET)

PET scan is the nuclear medicine technology that finds spots of cancer activity in the body. By injecting a small amount of radioactive glucose (sugar) into a vein, the scanner can capture images where the sugar collects and identify cancer cell activity. Some of these imaging tests, such as CT and PET, might also be used to see how well a patient’s cancer treatment is working.

4.Pancreatic Cancer- There is no single diagnostic test that can tell you if you have Pancreatic Cancer. Definitive diagnosis requires a series of imaging scans, blood tests and biopsy and those tests are typically only done if you have symptoms. At that point, since early pancreatic cancer does not usually show symptoms, the cancer has likely grown and even spread to other organs.

● Imaging tests

Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. Imaging tests might be done for a number of reasons both before and after a diagnosis of pancreatic cancer.

● Computed Tomography (CT) Scan

The CT scan makes detailed cross-sectional images of your body. CT scans are often used to diagnose Pancreatic Cancer because they can show the pancreas fairly clearly. They can also help show if cancer has spread to organs near the pancreas, as well as to lymph nodes and distant organs. A CT scan can help determine if surgery might be a good treatment option.

If your doctor thinks you might have Pancreatic Cancer, you might get a special type of CT known as a multiphase CT scan or a pancreatic protocol CT scan. During this test, different sets of CT scans are taken over several minutes after you get an injection of an intravenous (IV) contrast.

● CT-Guided Needle Biopsy: CT scans can also be used to guide a biopsy needle into a suspected pancreatic tumor. But if a needle biopsy is needed, most doctors prefer to use endoscopic ultrasound (described below) to guide the needle into place.

● Magnetic Resonance Imaging (MRI):

MRI scans use radio waves and strong magnets instead of X-rays to make detailed images of parts of your body. Most doctors prefer to look at the pancreas with CT scans, but an MRI might also be done.

Special types of MRI scans can also be used in people who might have Pancreatic Cancer or are at high risk:

o MR Cholangiopancreatography (MRCP), which can be used to look at the pancreatic and bile ducts, is described below in the section on cholangiopancreatography.
o MR Angiography (MRA), which looks at blood vessels, is mentioned below in the section on angiography.

● Ultrasound- Ultrasound (US) tests use sound waves to create images of organs such as the pancreas. The two most commonly used types for pancreatic cancer are:

1. Abdominal ultrasound: If it’s not clear what might be causing a person’s abdominal symptoms, this might be the first test done because it’s easy to do and it doesn’t expose a person to radiation. But if signs and symptoms are more likely to be caused by pancreatic cancer, a CT scan is often more useful.

2. Endoscopic Ultrasound (EUS): This test is more accurate than abdominal US and can be very helpful in diagnosing pancreatic cancer. This test is done with a small US probe on the tip of an endoscope, which is a thin, flexible tube that doctors use to look inside the digestive tract and to get biopsy samples of a tumor.

● Cholangiopancreatography- This is an imaging test that looks at the pancreatic ducts and bile ducts to see if they are blocked, narrowed or dilated. These tests can help show if someone might have a pancreatic tumor that is blocking a duct. They can also be used to help plan surgery. The test can be done in different ways, each of which has pros and cons.

● Endoscopic Retrograde Cholangiopancreatography (ERCP): For this test, an endoscope (a thin, flexible tube with a tiny video camera on the end) is passed down the throat, through the esophagus and stomach and into the first part of the small intestine. The doctor can see through the endoscope to find the ampulla of Vater (where the common bile duct empties into the small intestine). X-rays taken at this time can show narrowing or blockage in these ducts that might be due to Pancreatic Cancer. The doctor doing this test can put a small brush through the tube to remove cells for a biopsy or place a stent (small tube) into a bile or pancreatic duct to keep it open if a nearby tumor is pressing on it.

● Magnetic Resonance Cholangiopancreatography (MRCP): This is a non-invasive way to look at the pancreatic and bile ducts using the same type of machine used for standard MRI scans. Unlike ERCP, it does not require an infusion of a contrast dye. Because this test is non-invasive, doctors often use MRCP if the purpose is just to look at the pancreatic and bile ducts. But this test can’t be used to get biopsy samples of tumors or to place stents in ducts.

● Percutaneous Transhepatic Cholangiography (PTC): In this procedure, the doctor puts a thin, hollow needle through the skin of the belly and into a bile duct within the liver. A contrast dye is then injected through the needle and X-rays are taken as it passes through the bile and pancreatic ducts. As with ERCP, this approach can also be used to take fluid or tissue samples or to place a stent into a duct to help keep it open. As it’s more invasive (and might cause more pain), PTC is not usually used unless ERCP has already been tried or can’t be done for some reason.

● Positron Emission Tomography (PET) scan- For a PET scan, you are injected with a slightly radioactive form of sugar, which collects mainly in cancer cells. A special camera is then used to create a picture of areas of radioactivity in the body.

● Angiography- This is an X-ray test that looks at blood vessels. A small amount of contrast dye is injected into an artery to outline the blood vessels and then x-rays are taken.

An angiogram can show if blood flow in a particular area is blocked by a tumor. It can
Also show abnormal blood vessels (feeding the cancer) in the area. This test can be useful in finding out if a Pancreatic Cancer has grown through the walls of certain blood vessels. Mainly, it helps surgeons decide if the cancer can be removed completely without damaging vital blood vessels and it can also help them plan the surgery.

X-ray angiography can be uncomfortable because the doctor has to put a small catheter into the artery leading to the pancreas. Usually the catheter is put into an artery in your inner thigh and threaded up to the pancreas. A local anesthetic is often used to numb the area before inserting the catheter. Once the catheter is in place, the dye is injected to outline all the vessels while the X-rays are being taken.

Angiography can also be done with a CT scanner (CT angiography) or an MRI scanner (MR angiography). These techniques are now used more often because they can give the same information without the need for a catheter in the artery. You might still need an IV line so that a contrast dye can be injected into the bloodstream during the imaging.

● Blood Tests- Several types of blood tests can be used to help diagnose Pancreatic Cancer or to help determine treatment options.

● Liver Function Tests: Jaundice (yellowing of the skin and eyes) is often one of the first signs of Pancreatic Cancer. Doctors often get blood tests to assess liver function in people with jaundice to help determine its cause. Certain blood tests can look at levels of different kinds of bilirubin (a chemical made by the liver) and can help tell whether a patient’s jaundice is caused by disease in the liver itself or by a blockage of bile flow (from a gallstone, a tumor or other disease).

● Tumor Markers: Tumor markers are substances that can sometimes be found in the blood when a person has cancer. Tumor markers that may be helpful in Pancreatic Cancer are:

o CA 19-9
o Carcinoembryonic antigen (CEA), which is not used as often as CA 19-9

Neither of these tumor marker tests are accurate enough to tell for sure if someone has Pancreatic Cancer. Levels of these tumor markers are not high in all people with Pancreatic Cancer, and some people who don’t have Pancreatic Cancer might have high levels of these markers for other reasons. Still, these tests can sometimes be helpful, along with other tests, in figuring out if someone has cancer.

In people already known to have Pancreatic Cancer and who have high CA19-9 or CEA levels, these levels can be measured over time to help tell how well treatment is working. If all the cancer has been removed, these tests can also be done to look for signs of a relapse.

5. Prostate Cancer: Test that is commonly used to screen for Prostate Cancer are described below.

Prostate Specific Antigen (PSA) Test

A blood test called a prostate specific antigen (PSA) test measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have Prostate Cancer. The PSA level may also be elevated in other conditions that affect the prostate.

As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present. But many factors, such as age and race, can affect PSA levels. Some prostate glands make more PSA than others.

PSA levels also can be affected by:

● Certain medical procedures
● Certain medications
● An enlarged prostate
● A prostate infection

Because many factors can affect PSA levels, your doctor is the best person to interpret your PSA test results. If the PSA test is abnormal, your doctor may recommend a biopsy to find out if you have Prostate Cancer.

Diagnosing Prostate Cancer:

● Transrectal Biopsy of the Prostate – If Prostate Cancer screening detects an abnormality, your doctor may recommend further tests to determine whether you have Prostate Cancer, such as:

● Ultrasound- During a trans rectal ultrasound, a small probe, about the size and shape of a cigar, is inserted into your rectum. The probe uses sound waves to create a picture of your prostate gland.

● Magnetic Resonance Imaging (MRI)- In some situations, your doctor may recommend an MRI scan of the prostate to create a more detailed picture. MRI images may help your doctor plan a procedure to remove prostate tissue samples.

● Collecting a sample of prostate tissue- To determine whether there are cancer cells in the prostate, your doctor may recommend a procedure to collect a sample of cells from your prostate (prostate biopsy). Prostate biopsy is often done using a thin needle that’s inserted into the prostate to collect tissue. The tissue sample is analyzed in a lab to determine whether cancer cells are present.

6. Thyroid Cancer: Many cases of Thyroid Cancer can be found early. In fact, most Thyroid Cancers are now found much earlier than in the past and can be treated successfully.

● Most early Thyroid Cancers are found when patients see their doctors because of neck lumps or nodules they noticed. If you have symptoms such as a lump or swelling in your neck, you should see your doctor right away.
● Other Thyroid Cancers are found by health care professionals during a routine checkup.
● Early Thyroid Cancers are also sometimes found when people have imaging tests, such as ultrasounds or CT scans for other health problems.

● Blood tests- Blood tests help determine if the thyroid gland is functioning normally.

● Ultrasound imaging- Ultrasound uses high-frequency sound waves to create pictures of body structures. To create an image of the thyroid, the ultrasound transducer is placed on your lower neck. The appearance of your thyroid on the ultrasound helps your doctor determine whether a thyroid nodule is likely to be noncancerous (benign) or whether there’s a risk that it might be cancerous.

● Removing a sample of thyroid tissue- During a fine-needle aspiration biopsy, your doctor inserts a long, thin needle through your skin and into the thyroid nodule. Ultrasound imaging is typically used to precisely guide the needle into the nodule. Your doctor uses the needle to remove samples of suspicious thyroid tissue. The sample is analyzed in the laboratory to look for cancer cells.

● Other imaging tests- You may have one or more imaging tests to help your doctor determine whether your cancer has spread beyond the thyroid. Imaging tests may include CT, MRI and nuclear imaging tests that use a radioactive form of iodine.

● Genetic testing- Some people with medullary thyroid cancer may have genetic changes that can be associated with other endocrine cancers. Your family history may prompt your doctor to recommend genetic testing to look for genes that increase your risk of cancer.

7. Bladder Cancer: There is no standard or routine screening test for bladder cancer.

● Hematuria tests have been studied as a way to screen for Bladder Cancer.
● Two tests may be used to screen for Bladder Cancer in patients who have had bladder cancer in the past:
Urine Cytology

The following tests may be used to diagnose and learn more about Bladder Cancer:

● Urine tests. If your doctor has found any amount of blood in the urine, a urine cytology test can be ordered. Urine cytology often uses a random urine sample from normal urination to find out if the urine contains tumor cells. If a patient is undergoing a cystoscopy (see below), an additional test may be performed that involves rinsing the bladder and collecting the liquid through the cystoscope or through another small tube that is inserted into the urethra. The sample can be tested in a variety of ways. The most common way is to look at the cells under a microscope, called urinary cytology. There are other urine tests using molecular analysis that can be done to help find cancer, usually at the same time as urinary cytology.

● Cystoscopy. is the key diagnostic procedure for Bladder Cancer. It allows the doctor to see inside the body with a thin, lighted, flexible tube called a cystoscope. Flexible cystoscopy is performed in a doctor’s office and does not require anesthesia, which is medication that blocks the awareness of pain. This short procedure can detect growths in the bladder and determine the need for a biopsy or surgery.

● Biopsy/Transurethral Resection of Bladder Tumor (TURBT). If abnormal tissue is found during a cystoscopy, the doctor will do a biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. This surgical procedure is called a transurethral bladder tumor resection or TURBT.

8. Breast Cancer: Breast Cancer screening means checking a woman’s breasts for cancer before there are signs or symptoms of the disease. All women need to be informed by their healthcare provider about the best screening options for them. Although Breast Cancer screening cannot prevent Breast Cancer, it can help find Breast Cancer early, when it is easier to treat.

Breast Cancer Screening/ Diagnosing Tests

● Mammogram

A mammogram is an X-ray of the breast. For many women, mammograms are the best way to find Breast Cancer early, when it’s easier to treat and before it is big enough to feel or cause symptoms. Having regular mammograms can lower the risk of dying from Breast Cancer. At this time, a mammogram is the best way to find Breast Cancer for most women.

● Breast Magnetic Resonance Imaging (MRI)
A breast MRI uses magnets and radio waves to take pictures of the breast. MRI is used along with mammograms to screen women who are at high risk for getting Breast Cancer. Because breast MRIs may appear abnormal even when there is no cancer, they are not used for women at average risk.

Other Exams
Clinical Breast Exam

A clinical breast exam is an examination by a doctor or nurse, who uses his or her hands to feel for lumps or other changes.

Breast Self-Awareness

Being familiar with how your breasts look and feel can help you notice symptoms such as lumps, pain, or changes in size that may be of concern. These could include changes found during a self breast examination. You should report any changes that you notice to your doctor or healthcare provider.

9. Colorectal Cancer- Several screening tests can be used to find polyps or Colorectal Cancer. Under the guidelines below, people should begin Colorectal Cancer screening earlier and/or undergo screening more often if they have any of the following risk factors for Colorectal Cancer:

● A personal history of Colorectal Cancer or adenomatous polyps.
● A strong family history of Colorectal Cancer or polyps, such as cancer or polyps in a first-degree relative younger than 60 or in 2 first-degree relatives of any age. A first-degree relative is defined as a parent, sibling or child.
● A personal history of chronic IBD.
● A family history of any hereditary Colorectal Cancer syndrome, such as FAP, Lynch syndrome, or other syndromes.

The tests used to screen for Colorectal Cancer are described below.

● Colonoscopy – A colonoscopy allows the doctor to look inside the entire rectum and colon while a patient is sedated. A flexible, lighted tube called a colonoscope is inserted into the rectum and the entire colon to look for polyps or cancer. During this procedure, a doctor can remove polyps or other tissue for examination (see “Biopsy” in the Diagnosis section). The removal of polyps can also prevent Colorectal Cancer.

● Computed Tomography (CT or CAT) Colonography. CT colonography, sometimes called virtual colonoscopy, is a screening method being studied in some centers. It requires interpretation by a skilled radiologist to provide the best results.

● Sigmoidoscopy – A sigmoidoscopy uses a flexible, lighted tube that is inserted into the rectum and lower colon to check for polyps, cancer and other abnormalities. During this procedure, a doctor can remove polyps or other tissue for later examination. The doctor cannot check the upper part of the colon, the ascending and transverse colon, with this test. This screening test allows for the removal of polyps, which can also prevent Colorectal Cancer, but if polyps or cancer are found using this test, a colonoscopy to view the entire colon is recommended.

● Fecal Occult Blood Test (FOBT) and Fecal Immunochemical Test (FIT). A fecal occult blood test is used to find blood in the feces, or stool, which can be a sign of polyps or cancer. A positive test, meaning that blood is found in the feces, can be from causes other than a colon polyp or cancer, including bleeding in the stomach or upper GI tract and even eating rare meat or other foods.

● Stool DNA Tests. This test analyzes the DNA from a person’s stool sample to look for cancer. It uses changes in the DNA that occur in polyps and cancers to find out if a colonoscopy should be done.

Apart from the above mentioned, there are other tests that can be used to diagnose Colorectal Cancer:

● Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis of Colorectal Cancer. A pathologist then analyzes the sample or samples.

● Biomarker Testing of the Tumor. Your doctor may recommend running laboratory tests on a tumor sample to identify specific genes, proteins and other factors unique to the tumor.

● Blood Tests. Because Colorectal Cancer often bleeds into the large intestine or rectum, people with the disease may become anemic. A test of the number of red cells in the blood, which is part of a complete blood count (CBC), can indicate that bleeding may be occurring.

● Another blood test detects the levels of a protein called carcinoembryonic antigen (CEA). High levels of CEA may indicate that a cancer has spread to other parts of the body. CEA is not a perfect test for Colorectal Cancer because levels are high for only about 60% of people with Colorectal Cancer that has spread to other organs from the colon. In addition, other medical conditions can cause CEA to increase. A CEA test is most often used to monitor Colorectal Cancer for people who are already receiving treatment. It’s not useful as a screening test.

10. Endometrial Cancer: The best way to find Endometrial Cancer when it’s small (at an early stage) is to see a healthcare provider if you have any signs and symptoms of Endometrial Cancer, such as abnormal vaginal bleeding or discharge (that’s getting worse, occurring between periods, or happening after menopause). Early detection improves the chances that the cancer will be treated successfully.

Most women with Endometrial Cancer have abnormal vaginal bleeding. Still, some Endometrial Cancers may reach an advanced stage before causing signs and symptoms. This means the cancer is big and may have spread before it causes any problems that are noticed.

There is no standard or routine screening test for Endometrial Cancer.

Tests and procedures used to diagnose Endometrial Cancer include:

● Examining the pelvis- During a pelvic exam, your doctor carefully inspects the outer portion of your genitals (vulva), and then inserts two fingers of one hand into your vagina and simultaneously presses the other hand on your abdomen to feel your uterus and ovaries. He or she also inserts a device called a speculum into your vagina. The speculum opens your vagina so that your doctor can view your vagina and cervix for abnormalities.

● Using sound waves to create a picture of your uterus- Your doctor may recommend a transvaginal ultrasound to look at the thickness and texture of the endometrium and help rule out other conditions. In this procedure, a wandlike device (transducer) is inserted into your vagina. The transducer uses sound waves to create a video image of your uterus. This test helps your doctor look for abnormalities in your uterine lining.

● Using a scope to examine your endometrium- During a hysteroscopy, your doctor inserts a thin, flexible, lighted tube (hysteroscope) through your vagina and cervix into your uterus. A lens on the hysteroscope allows your doctor to examine the inside of your uterus and the endometrium.

● Removing a sample of tissue for testing- To get a sample of cells from inside your uterus, you’ll likely undergo an endometrial biopsy. This involves removing tissue from your uterine lining for laboratory analysis. Endometrial biopsy may be done in your doctor’s office and usually doesn’t require anesthesia.

● Performing surgery to remove tissue for testing- If enough tissue can’t be obtained during a biopsy or if the biopsy results are unclear, you’ll likely need to undergo a procedure called dilation and curettage (D&C). During D&C, tissue is scraped from the lining of your uterus and examined under a microscope for cancer cells.

11. Cervical Cancer- Screening tests include:

● Pap test. During a Pap test, your doctor scrapes and brushes cells from your cervix, which are then examined in a lab for abnormalities.

A Pap test can detect abnormal cells in the cervix, including cancer cells and cells that show changes that increase the risk of Cervical Cancer.

● HPV DNA test. The HPV DNA test involves testing cells collected from the cervix for infection with any of the types of HPV that are most likely to lead to Cervical Cancer.

When to Get Screened?
If You Are 21 to 29 Years Old

You should start getting Pap tests at age 21. If your Pap test result is normal, your doctor may tell you that you can wait three years until your next Pap test.

If You Are 30 to 65 Years Old

Talk to your doctor about which testing option is right for you:

● A Pap test only- If your result is normal, your doctor may tell you that you can wait three years until your next Pap test.
● An HPV test only- This is called primary HPV testing. If your result is normal, your doctor may tell you that you can wait five years until your next screening test.
● An HPV test along with the Pap test- This is called co-testing. If both of your results are normal, your doctor may tell you that you can wait five years until your next screening test.
If You Are Older Than 65
Your doctor may tell you that you don’t need to be screened anymore if:

● You have had normal screening test results for several years, or
● You have had your cervix removed as part of a total hysterectomy for non-cancerous conditions, like fibroids.


If Cervical Cancer is suspected, your doctor is likely to start with a thorough examination of your cervix. A special magnifying instrument (colposcope) is used to check for abnormal cells.

During the colposcopic examination, your doctor is likely to take a sample of cervical cells (biopsy) for laboratory testing. To obtain tissue, your doctor may use:

● Punch biopsy, which involves using a sharp tool to pinch off small samples of cervical tissue.
● Endocervical curettage, which uses a small, spoon-shaped instrument (curet) or a thin brush to scrape a tissue sample from the cervix.


Tags: cancer, cancer screening, laboratory tests, diagnosis, lung cancer, CT scan, cervical cancer, self-examination, diagnosis, low-dose computed tomography , melanoma, pap smear test, ultra sound, endometrium, Sigmoidoscopy, biopsy, Non-Hodgkin’s lymphoma, blood test, imaging test, bladder cancer, prostate cancer, False positives. , Increased testing, false reassurance, HPV test, Mammogram, Breast Magnetic Resonance Imaging (MRI), fecal occult blood test (FOBT) and fecal immunochemical test (FIT). A fecal occult blood test , Stool DNA tests, Positron Emission Tomography (PET), pancreatic cancer, Prostate Specific Antigen (PSA) Test, colonoscopy , Computed tomography (CT or CAT) colonography, CT colonography, Magnetic resonance cholangiopancreatography (MRCP), Percutaneous transhepatic cholangiography (PTC), Positron emission tomography (PET) scan, Angiography, Tumor markers,CA 19-9, Carcinoembryonic antigen (CEA), colorectal cancer, MR cholangiopancreatography (MRCP), MR angiography (MRA), Ultrasound, Abdominal ultrasound, Endoscopic ultrasound (EUS), Cholangiopancreatography, Endoscopic retrograde cholangiopancreatography (ERCP), endometrial cancer, thyroid cancer