Q&A Topic: Benefits and Risks of Cancer Screenings

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Thomas Lester, MD

Q. Which cancer screenings are important to have and when should I have them?

A. Not only does the answer depend on many factors such as your age, gender, family history, and personal medical history, it is further complicated by the fact that screening recommendations can vary depending on the issuing organization. According to the Centers for Disease Control and Prevention, without question, the number of adults receiving recommended screening tests for colorectal, breast, and cervical cancers falls short of the nation’s goals.

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Q. Are there any risks involved in undergoing cancer screenings?

A. Risks of cancer screenings include false positives, false negatives, and the fact that a cancer found through screening will likely be aggressively treated even though it may not affect the person in their lifetime. A false positive, which erroneously indicates an abnormality, typically leads to a biopsy and possible surgery—both “invasive procedures with inherent risks.” The more sensitive the test—for example, the mammogram and 3D mammogram—the more likely a false positive will result. Twenty to 40 percent of biopsies performed based on mammograms are positive for cancer. Therefore, out of every five women who undergo a biopsy, at least one will be positive for cancer.False negatives, which falsely indicate the absence of abnormality, inevitably occur as well because none of the screenings are perfect. What’s more, when a screening detects something tiny, there remains no clear consensus as to what size nodule warrants a biopsy. As a result, some nodules do slip through.

Q. In the majority of cases, do the benefits outweigh the risks for routine cancer screenings?

A. The great benefit of routine cancer screenings is the early detection of a cancer, which is always more treatable. In the case of colon cancer, it makes the difference between simply removing a polyp, and major surgery with possible chemotherapy and radiation. The earlier you find the cancer, the less treatment required.

Q. How do I make a decision about having a cancer screening?

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A. The take-away for you and your family? There are certain screenings you should have. But the timing needs to be individualized. Speak with your physician about what makes sense for you. Also, discuss the consequences of false positives and negatives, and the appropriate course of action if cancer is found.

Q. Can you provide any guidelines for determining when to schedule cancer screenings?

A. The chart below can be used as a guide when scheduling your cancer screening tests and as a conversation starter when speaking to your physician about what is specifically recommended for you. These guidelines are for average-risk patients only, not for patients with risk factors, of which there are many.CANCER SCREENING GUIDELINES* These screening recommendations do not apply to those considered high-risk or at-risk. Modified guidelines may apply to your specific condition. Discuss these screenings with your physician to determine what is best for you.

Northern Westchester Hospital
Chief of Hematology and Medical Oncology,
Cancer Treatment & Wellness Center
Learn More About Dr. Lester

Learn more about:
cancer prevention, diagnosis and treatment

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Northern Westchester Hospital is a proud member of Northwell Health (formerly North Shore-LIJ Health System).

Screening Patient Profile Recommendation*
Colorectal Cancer Adults beginning at age 50 Colonoscopy
Cervical Cancer Women beginning at age 21 until age 65 Pap smear with HPV testing every 3 years. Annual gynecologic visits.
Breast Cancer Women beginning at age 40 Annual mammogram
Prostate Cancer Men beginning at age 50 until age 70 Age-adjusted PSA test
Lung Cancer Adults aged 55 to 74 years; Smoking history of 30 pack years (one pack a day for 30 years, two packs daily for 15 years, 3 packs daily for 10 years); Currently smoke or have quit within the past 15 years; No symptoms of lung cancer Annual low-dose computed tomography (LDCT)









































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