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CANCER SCREENING

Checking for cancer (or for conditions that may lead to cancer) in people who have no symptoms is called screening.
by

vibhav bansal

on 18 April 2012

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Transcript of CANCER SCREENING

CANCER SCREENING Some types of cancer can be found before they cause symptoms. Checking for cancer (or for conditions that may lead to cancer) in people who have no symptoms is called screening. Screening can help doctors find and treat some types of cancer early. Generally, cancer treatment is more effective when the disease is found early. However, not all types of cancer have screening tests and some tests are only for people with specific genetic risks. What Is Cancer Screening?
NEED FOR CANCER SCREENING ?
Recognizing possible warning signs of cancer and taking prompt action leads to early diagnosis
Small goal Greatly increases the chances for successful treatment
Main goal Some early signs of cancer include lumps, sores that fail to heal, abnormal bleeding, persistent indigestion, and chronic hoarseness etc.

Early diagnosis is particularly relevant for cancers of the breast, cervix, mouth, larynx, colon and rectum, and skin.
METHODS OF SCREENING
INTRODUCTION ADVANTAGES SCREENING METHOD Colonoscopy DISADVANTAGES In this we examines inside the rectum and entire colon using a long, lighted tube called a colonoscope
Aormally done after every 10 years The most complete screening method available, identifying and removing polyps in one session.
Sedation is given to patient to minimize discomfort.
Screens full colon.
Depending on results may only need to be re-screened every 10 years. Typically requires 1 day of clear liquids & laxative preparation.
Small risk of perforation or bleeding.
May be expensive if your health insurance does not cover this procedure.
Will need to set aside a day for procedure and have a ride home in order to leave the medical facility. Computed Tomographic Colonography (virtual colonoscopy) Uses x-rays and computers to take 2- or 3-dimensional images of your colon and rectum.

Every 5 years Can identify polyps that are >5mm before they turn into cancer.
Usually does not require sedation.
Identifies lesions in the entire colon and lower belly.
Less invasive than a colonoscopy.
Less risk of complications than colonoscopy. Polyps cannot be removed during the screening process -- will need to get a colonoscopy if test is positive.
May be expensive.
Requires liquid diet and bowel preparation beforehand.
May miss smaller polyps.
Not yet widely available. SCREENING METHOD INTRODUCTION ADVANTAGES DISADVANTAGES Flexible sigmoidoscopy

SCREENING METHOD Examines your rectum and the lower part of the colon with a lighted tube called a sigmoidoscope.

Every 5 years INTRODUCTION Can identify polyps before they turn into cancer.
Usually does not require sedation.
Moderate cost; covered by most insurance.
Many primary care providers can do the test in their office.
Can accurately find polyps in the lower part of the colon (where most polyps occur). ADVANTAGES Polyps cannot be removed during the procedure but they can be biopsied -- will need to get a colonoscopy if biopsy is positive for colorectal cancer.
Requires enema preparation.
Patients may find test uncomfortable or embarrassing.
Small risk of perforation or bleeding.
Does not screen the upper section the colon. DISADVANTAGES Double-contrast barium enema

SCREENING METHOD Air and barium are pumped into your rectum. The solution will show any polyps or tumors on x-rays.

Every 5-10 years INTRODUCTION Less expensive than a colonoscopy.
Does not require sedation.
Identifies lesions in the entire colon.
Accurate for finding abnormalities, such as narrowed areas or pockets or sacs in the intestinal wall. DISADVANTAGES Polyps cannot be removed during the screening process -- will need to get a colonoscopy if test is positive.
Requires laxative preparation.
Patients may find test uncomfortable or embarrassing.
Availability is decreasing; usually only for patients who cannot undergo colonoscopy. ADVANTAGES REFERENCES http://www.who.int/cancer/detection/en/ http://www.cancer.gov/cancertopics/screening http://www.nlm.nih.gov/medlineplus/ency/article/002071.htm http://www.ccalliance.org/screening/methods.html 1) COLON CANCER SCREENING PRESENTED BY: VIBHAV BANSAL JYOTI SEN C. PRATHIBHA APOORVI 2) BREAST CANCER SCREENING (cc) photo by medhead on Flickr Mammography SCREENING METHOD Mammography is a type of radiography used on the breasts. Mammography is not useful in finding breast tumors in dense breast tissue characteristic of women under 40 years. It is typically used for two purposes: to aid in the diagnosis of a woman who is experiencing symptoms (called diagnostic mammography), and for medical screening of apparently healthy women (called screening mammography). In women over 50 without dense breasts, breast cancers detected by screening mammography are usually smaller and less aggressive than those detected by patients or doctors as a breast lump. This is because the most aggressive breast cancers are found in dense breast tissue which mammograms can not image. INTRODUCTION How it works? Women who agree to be screened have their breasts X-rayed on a specialized X-ray machine. The image is then taken on plain photographic film or digital mammography on a computer screen DRAWBACKS mammography can create a high psychological and financial cost. Most women participating in mammography screening programs accept the risk of false positive recall Breast MRI SCREENING METHOD INTRODUCTION Magnetic resonance imaging (MRI) has been shown to detect cancers not visible on mammograms. The chief strength of breast MRI is its very high negative predictive value. A negative MRI can rule out the presence of cancer to a high degree of certainty, making it an excellent tool for screening in patients at high genetic risk or radiographically dense breasts, and for pre-treatment staging where the extent of disease is difficult to determine on mammography and ultrasound. MRI can diagnose benign proliferative change, fibroadenomas, and other common benign findings at a glance, often eliminating the need for costly and unnecessary biopsies or surgical procedure DISADVANTAGE Less specific than mammography Relatively expensive procedure Requires the intravenous injection of gadolinium, which has been implicated in a rare reaction called nephrogenic systemic fibrosis MRI may not be used for screening patients with a pacemaker or breast reconstruction patients with a tissue expander due to the presence of metal. http://en.wikipedia.org/wiki/Breast_cancer_screening Ultrasound is an imaging test that sends high-frequency sound waves through your breast and converts them into images on a viewing screen. The ultrasound technician places a sound-emitting probe on the breast to conduct the test. There is no radiation involved. ULTRASOUND 3) Cervical cancer screening Conventional PAP Smear In the conventional Pap smear, the physician collecting the cells smears them on a microscope slide and applies a fixative. In general, the slide is sent to a laboratory for evaluation.
Studies of the accuracy of conventional cytology report:
sensitivity 72%
specificity 94% http://www.breastcancer.org/symptoms/testing/new_research/index.jsp?gclid=COaW3K7ctq8CFUx76wodtWxUiA Fluid sampling technics with automated thin layer preparation Two such technics that have been extensively tested are:
ThinPrep (Cytyc Corp, Booxborough, MA)
Autocyte (TriPath Imaging, Burlington, NC). A special sampling device is used for sampling the cervix in
the usual manner as in the traditional Pap smear. The sampling
device is then directly placed in a vial containing a special
preservative with additional hemolytic and mucolytic agents.
The general idea is to provide a well preserved sample that is
automatically transferred to a slide as a coin sized thin layer.
In the laboratory, the cells are collected either by extraction
across a special filter (ThinPrep) or by layering onto a density
reagent. Automated screening technology The following automated screening technics are used:
Autopap300 (TriPath Imaging, Burlington NC)
PAPNET (Neuromedical systems). 1) Autopap300 system utilizes a specialized high speed video microscope, image interpretation software, and specially designed field of view computers to image, analyze and classify abnormal cervical cells. The screened slides are given a score and adequacy statement. 2) PAPNET 19 is a semi-automated system, which consists of two phases, a scanning phase and a review phase for cervical smears. After identification of 128 cells with the highest network score, the cytologists are required to only review those cells. HPV-DNA Testing The etiopathological role of HPV in the development of cervical cancer has been proved beyond doubt. There are various technics available for HPV-DNA testing of which Southern Blot hybridization is regarded as a laboratory gold standard. Currently the Hybrid capture II assay (Digene, Silver Spring, MD) is the most useful technic for HPVDNA testing. This utilizes nonradioactive RNA probes in a modified ELISA procedure to report the presence or absence of 13 strains of high risk HPV-DNA. http://medind.nic.in/jaq/t06/i2/jaqt06i2p115.pdf (cc) photo by theaucitron on Flickr NEW TECHNOLOGIES IN CANCER SCREENING
Novel Cancer Detection Method Uses Tiny Silica Beads To Adhere To Cells By Sokolov et al. The method uses nonspecific adhesion of silica beads to cells. Based on the difference in surface physical properties of cancerous and normal human epithelial cervical cells. The difference in the brush was expected to lead to the differences in the adhesion of various particles to such cells. The adhesion was studied with the help of atomic force microscopy (AFM). The difference in adhesion, which has an essentially physical nature, was used to distinguish between cancerous and normal cells http://www.sciencedaily.com/releases/2009/11/091106194235.htm New Colon Cancer Screening Tests the DNA in Your Poop Cells sloughed off from your colon during a bowel movement end up in your feces and the DNA in those cells is tested to see if any them have become cancerous. In this we look for specific proteins and genetic markers, primarily those associated with the K-RAS and APC genes. Methylation markers, mutation markers, hemoglobin markers are all flags that a cell has become cancerous. http://singularityhub.com/2010/11/12/new-colon-cancer-screening-tests-the-dna-in-your-poop-video/ Automated Breast Ultrasound Detailed image of dense breast tissue, helping them better spot tumors. It works as the device provides 3-D images of breast tissue and is intended for use along with mammograms. http://thestir.cafemom.com/healthy_living/136052/womens_lives_could_be_saved http://www.aafp.org/afp/2001/0901/p780.html
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