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What You Should Know About Cancer, with Dr Robert Smith

By Dr. Robert Smith, American Cancer Society – Senior Director, Cancer Screening

Cancer is a major health problem around the world, but much of the suffering and premature death from cancer could be prevented by detecting and treating it early. In fact, the prognosis of most cancers is better when they are found and treated early, and early diagnosis often means treatment can be less aggressive and debilitating.

Geoffrey Grandjean, researcher at MD Anderson Cancer in the US, took this image of an ovarian cancer cell using the GE Healthcare IN Cell Analyzer 1000.

Fluorescence micrograph of ovarian cancer cells.

1) What is the best screening test for me?

The goal of cancer screening is to reduce the risk of being diagnosed with cancer at an advanced stage. Cancer screening is the application of a test in healthy adults without signs and symptoms of cancer in order to detect it early. For cancers of the cervix or colon and rectum, a goal of cancer screening is not only to find cancer early, but to find abnormalities that may become cancer, which – if treated – can prevent these cancers from occurring. The American Cancer Society recommends that women begin screening for cervical cancer at age 21 with a Pap test every 3 years. After age 30, women can continue with testing every 3 years or have a Pap test and a test for human papillomavirus (HPV) every 5 years.

Women should begin screening for breast cancer at age 40 with annual mammograms. Women and men should begin screening for colorectal cancer at age 50 either with a high sensitivity stool test every year, a CT colonography (an x-ray exam) every 5 years, or a colonoscopy every 10 years, depending on which test they prefer. Men and women who are between the ages of 55-74 and are current or former (quit within the past 15 years) smokers with a history of 30 pack years or more of smoking should undergo annual lung cancer screening with a CT exam. Finally, men age 50 and older should have a discussion with their doctors about prostate cancer screening. Individuals who are at higher risk may need to begin screening earlier, be screened more frequently, and may need to use different tests. Visit the American Cancer Society at for more information.

Screening refers to tests and exams used to find a disease, such as cancer, in people who do not have any symptoms. Breast cancers found during screening exams are more likely to be smaller and still confined to the breast. 

Mammogram of healthy breast tissue.

2) Why is it important to find cancer early?

Most cancers have better survival and are treated more easily if they’re found early. So, not only is it important to follow the recommendations and get regular cancer screening, but also to be alert to signs and symptoms of cancer. Only a few screening tests have been proven to save lives such as those in place to screen for breast, cervical, colorectal, lung, and prostate cancers – and even these tests will not always find a cancer if it’s present. Thus, remaining alert for signs and symptoms of cancer is important.

3) What [are some common] signs and symptoms of cancer that should I look for?

Most signs and symptoms of cancer are associated with the site of the cancer. Most often these signs and symptoms are not cancer, but it’s important not to take chances. See your doctor right away. Symptoms of breast cancer most commonly present as a painless lump or thickening in the breast, redness, nipple discharge, or a change in the appearance of the nipple. For colorectal cancer, rectal bleeding, blood in the stool, or a change in bowel habits are common symptoms. Symptoms of lung cancer may include a persistent cough, sputum streaked with blood, chest pain, voice change, and recurrent bouts with pneumonia or bronchitis. The most common symptom of cervical cancer is vaginal bleeding. Men with prostate cancer may experience weak or interrupted urine flow or the need to urinate frequently, blood in the urine, or pain in the hips, spine, or other areas.

Cancerous ling cell 690x460

Fluorescence micrograph of a lung cancer cell.

4) What do you do if you find a sign or symptom?

Unfortunately, too often individuals with signs and symptoms of cancer delay seeing their doctor due to uncertainty about the symptoms or fear. The most important thing to do if you detect a change that is associated with signs and symptoms of cancer is to see your doctor immediately.

5) How do I motivate a friend or family member to get screened?

The single most important influence on whether or not an adult gets screened for cancer is a recommendation from their doctor. If you have a friend or family member who has not been screened, remind them that their health is important to you and that they should talk with their doctor about getting current on their cancer screening tests.

6) What is the biggest barrier to finding cancer early?

There are several common barriers to finding cancer early. The most common reason adults give for not having had a cancer screening test is that their doctor didn’t recommend it. Another common barrier has been cost due to either not having health insurance or facing a high out of pocket costs. However, for most adults, changes in health insurance brought about by the Affordable Care Act mean cancer screening will be fully covered with no out of pocket costs.