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Do you know | 9 common ways to screen for cancer early on World Cancer Day?

February 4 is World Cancer Day

Early screening for cancer

Choosing the right project is crucial

Do you know | 9 common ways to screen for cancer early on World Cancer Day?

Through scientific prevention and screening, cancer morbidity and mortality can be reduced. Most common cancers have sensitive detection.

Lung cancer –

Low-dose CT

Among the traditional screening methods for lung lesions, the most common is X-ray examination, which is often called chest radiograph. However, chest x-rays are less sensitive to lung cancer and can only be detected when the nodules are larger than 1 cm, and it is difficult to judge the nature, so further examinations are required. Lung cancer is detected with CT with high resolution, and tumors can be detected when they reach 1 cm or even 0.8 cm.

Therefore, it is recommended that people over 50 years old or people with a family history of lung cancer replace X-rays with low-dose CT during physical examination. The 2020 edition of the "Recommendations for Screening and Prevention of Common Malignant Tumors in Residents" also recommends that low-dose CT screening should be performed for high-risk groups of lung cancer.

Stomach cancer –

Gastroscopy + biopsy

Do you know | 9 common ways to screen for cancer early on World Cancer Day?

Gastric cancer refers to an epithelial-derived malignancy that originates in the stomach and increases with age. The risk of disease in men is 6~8 times higher than that of women. China accounts for about 40% of the 1.2 million new cases of gastric cancer in the world every year, making it the country with the highest incidence of gastric cancer in the world. However, the proportion of early-stage gastric cancer in mainland China is relatively low, less than 20%, and most patients are already advanced gastric cancer when they are discovered. Gastroscopy is the most common examination method for esophageal, gastric and duodenal diseases, which can detect gastrointestinal ulcers, inflammation and tumors, determine the location of gastrointestinal bleeding, and detect precancerous lesions of the digestive tract early.

Generally speaking, people with atrophic gastritis, gastric tumors and gastric ulcers are recommended to do gastroscopy and biopsy in order to prevent and treat gastric cancer early.

Colorectal Cancer –

Electronic colonoscopy

90% of bowel cancers develop from polyps, and it takes about 10 years to develop from polyps to cancer. In this process, if the polyp is detected in time at an early stage and removed, subsequent re-examination can effectively avoid the occurrence of bowel cancer. Therefore, I urge everyone to start colonoscopy after the age of 40. 55 years old is the high incidence age of bowel cancer, it is recommended that everyone pay attention to colonoscopy as a screening method.

Esophageal cancer –

Endoscopy

Do you know | 9 common ways to screen for cancer early on World Cancer Day?

Endoscopy is a direct examination of the mucous membranes of the digestive organs through electronic lenses or endoscopes. When esophageal cancer is examined endoscopy, the location, size, spread, surface shape, number of lesions, color, and depth of invasion can be intuitively understood. Endoscopy can also directly obtain cell tissues and perform pathological examination on cell tissues, which is conducive to the diagnosis of the disease.

Regular examinations are recommended every three years for the following people without special conditions: first-degree relatives with a history of esophageal cancer; Living in an area with a high incidence of esophageal cancer; Long-term poor eating habits, smoking, drinking or liking to eat pickled foods, etc.; People with symptoms of reflux esophagitis.

Liver Cancer –

Alpha-fetoprotein + liver ultrasound

To detect liver cancer, a combination of "alpha-fetoprotein + B ultrasound" is required. Alpha-fetoprotein is a tumor marker that can be detected by collecting venous blood. This indicator remains low one year after birth and rises only when liver disease occurs, and is one of the routine indicators for clinical diagnosis of primary liver cancer.

It should be noted that the use of alpha-fetoprotein census alone will have a certain missed diagnosis rate, because only about 80% of liver cancer patients alpha-fetoprotein will be elevated, that is to say, simply detecting normal serum alpha-fetoprotein values still cannot completely exclude the possibility of liver cancer. Years of clinical experience have proved that the accuracy of liver B ultrasound combined with serum alpha-fetoprotein detection of liver cancer reaches more than 90%, which is the preferred examination method for clinical diagnosis of early liver cancer.

High-risk groups who need to be regularly screened for the above two liver cancers include patients with viral hepatitis, fatty liver, liver cirrhosis, people who consume aflatoxin in excess of the standard, and people with a family history of liver cancer.

Breast cancer –

Mammography and mammography examination

Mammary ultrasound has the characteristics of non-invasive, non-radiation, easy to operate and cheap. It can accurately distinguish the cystic and solid nature of breast masses, can find nodules or lumps of more than 5 mm, and can be used in the exploration of axillary lymph nodes and lymph nodes in the breast drainage area. Ultrasound is a radiation-free, painless breast cancer screening method for women who are not candidates for x-rays (eg, pregnant women). Ultrasonography has a higher rate of lesion detection in women with dense breasts, allowing a more comprehensive view of the entire breast and reducing the missed rate of breast cancer.

X-ray examination for breast cancer, also known as molybdenum palladium examination, is recommended for women over 35 years old with large breasts to pay attention to mammogram examination. The breast tissue of such women is relatively loose, and the results of mammogram imaging are better. The recognition rate of microcalcifications by this examination reaches more than 95%, and 85%~90% of breast cancers can be detected and some breast cancers with negative clinical palpation can be found.

Do you know | 9 common ways to screen for cancer early on World Cancer Day?

How should these two tests be selected for breast screening? Each inspection has its advantages and limitations. Oriental women have small breasts and fine mammary glands, which should be mainly ultrasound and supplemented by mammography as the supplement. Women can have color ultrasound every year, plus mammograms after age 40. If there is no problem with color ultrasound and mammogram X-ray, it can be checked again with mammogram two or three years later.

In addition, breast cancer is not a "patent" for women, and men can also develop breast cancer, but it is very rare. Once men develop breast cancer, the condition tends to be more severe than that of women, and the survival rate is lower than that of women. Male breast cancer screening methods are similar to female patients, mainly ultrasound and mammography, and if necessary, localization needle biopsy can be performed.

Cervical Cancer –

HPV+TCT

Cervical cancer is the only cancer with a clear etiology among all human cancers that can be eliminated through early screening and early treatment. Cervical cancer is caused by infection with papillomavirus (HPV), which means that early prevention and treatment of cervical cancer is more effective in targeting the cause. At present, the safest screening method for cervical cancer is internationally recognized as the combination of cytology (TCT) and human papillomavirus (HPV) virological testing. The industry also regards HPV+TCT combined screening as the best way to accurately screen or secondary cervical cancer prevention and control.

Cervical cancer screening should be done in the following people: people who have had unclean sex and have been infected with STDs; People with young sexual life; Premature or multiple deliveries; Patients with cervical lesions or other gynaecological conditions. In addition, if a woman has recently experienced vaginal bleeding and abnormal vaginal discharge, cervical cancer screening should also be performed.

Ovarian Cancer –

CA125+ pelvic ultrasound

CA125 is also a tumor marker, and serum CA125 concentration determination is the most widely used biochemical method in early screening of ovarian cancer. In recent years, the incidence and mortality of cancer have shown a trend of increasing year by year, and cancer prevention and treatment cannot be delayed. Serum CA125 values are elevated in approximately 50% of patients with early-stage ovarian cancer and more than 80% of patients with advanced ovarian cancer, and the degree of elevated concentration is related to tumor burden and stage.

Pelvic ultrasonography can clearly show pelvic organs and lesions, and sonographers can detect ovarian lesions early based on the size, morphology, blood flow, and vascular distribution of the ovaries measured. With the development of ultrasound technology, ultrasound will play a more important role in evaluating ovarian lesions. However, ultrasound cannot clearly distinguish ovarian cancer from common ovarian disease (benign ovarian mass, internal heterogeneity). At present, the above two methods are mainly used in clinical practice to screen ovarian cancer early.

Do you know | 9 common ways to screen for cancer early on World Cancer Day?

For ovarian cancer screening, there is currently no unified screening strategy like breast cancer and cervical cancer. Patients need to communicate fully with their doctor before deciding whether and how to screen.

Prostate Cancer –

PSA

Cervical and ovarian cancer are types of tumors specific to women, and likewise, men also have cancers that are endemic to men, which is prostate cancer. It is recommended that men over the age of 50 use the prostate-specific antigen (PSA) program to screen for prostate cancer. The item is also checked by blood tests. Because PSA is cheap, after systematic identification and exclusion of false positives, PSA has become the most convenient, sensitive and specific method for early screening of prostate cancer.

The above cancer screening methods have been widely used in mainland China in recent years, and it is easy to identify cancer types. I hope that during the physical examination, you can choose the corresponding examination according to your own situation, early screening, early detection, and early treatment, so as not to leave regrets in life and enjoy a beautiful and healthy life.

Source: Public Health magazine

Author: Du Peng, Chairman of the Early Cancer Screening Professional Committee of Beijing Anti-Cancer Association and Chief Physician of the Department of Urology, Peking University Cancer Hospital 

Tang Xiaohu, Deputy Chief Physician of Urology, Peking University Cancer Hospital

Curator: Wu Weihong, Tan Jia

Editor: Luan Zhaolin

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