Special to the Citizen
Many of us don’t love the idea of going in for a colonoscopy or mammogram, and even the idea of a needle stick might make some of us jittery. But when it comes to cancer screenings, those tests can mean the difference between a treatable – even curable – cancer, and one that’s far tougher to beat.
In recent years, there’s been a trend towards evidence-based medicine – looking at the evidence and deciding what works and what doesn’t. The good news is that the medical evidence sometimes points to fewer tests. Here are some of the more significant changes you might notice at your next doctor visit, plus tips on how to make screenings easier on yourself.
What’s new for women?
If you’re still getting annual mammograms, you might be able to have them less often. According to the United States Preventive Services Task Force (USPSTF), women at average risk of breast cancer need screening only every two years from ages 50 to 74. Everyone’s situation is different, so talk to your doctor and together decide what’s right for you.
Likewise, most women don’t need once-a-year Pap tests. According to a 2012 change in guidelines, women ages 21 to 65 at average risk need this cervical cancer screening just once every three years. If you’re 30 to 65, you can get a DNA test as well as a Pap, which lets you go five years between tests (if your doctor agrees). That said, you’ll still want to go in for an annual wellness visit.
What’s different for men?
Not as much to report here, guys, but if your doctor is still ordering a prostate-specific antigen (PSA) test during your annual exam, you might want to talk about it. In 2012, the USPSTF recommended against routine PSA tests as a way to screen for prostate cancer. A high PSA level doesn’t necessarily signal cancer, but could lead to unneeded treatments. While PSA test rates have been going down, a recent study found that around 40 percent of men over age 60 were still getting them.
The latest on colon screenings
If you’re between 50 and 75, you probably know that you need regular colon cancer screenings. You have a growing number of options now, and they all generally involve a tradeoff between thoroughness and the length of time between screenings. In particular, more insurance companies have started to cover virtual colonoscopies (Medicare is a notable exception).
Unlike traditional colonoscopies that use a camera to look inside your colon, a virtual colonoscopy is basically a CT scan (these scans use a series of X-rays to create sharp images). Normal results on an old-style colonoscopy can often get you off the hook for 10 years; the virtual version needs to be repeated every five years.
There are also several simple lab tests that involve collecting a little stool at home and mailing it in to the lab. The newer FIT tests look at immune markers and are more sensitive than older ones. Depending on the test, these need to be done every one to three years.
How to get over your reluctance
If you’re not a fan of getting tested, you’re not alone. Millions of Americans aren’t getting essential tests, and cancer screening rates are lowest among U.S. Latinos and Asians.
If cost is an issue, you might be happy to know that health plans under the Affordable Care Act must cover most preventive care at no cost to you (no co-pays, deductibles or coinsurance). If you have a plan that predates the 2010 law, your coverage may be different.
Just a few simple ways you can make screenings easier for yourself.
* Ahead of your annual exam, check out which exams and preventive care are recommended for you by visiting GetScreenedNow.org, a collaboration between Stand Up To Cancer and Rally Health.
* Schedule your screenings and lab tests before you leave your primary care doctor’s office.
* When picking a day and time, think of how you might feel. Depending on the test, pick time of day that works best for you.
* On the day of your appointment, take someone along (for some tests you’ll be sedated so you’ll definitely need a driver).
* Make sure you’re as comfortable as possible. If you tend to get cold, bring a wrap or take socks.
* Before you leave, ask when you can expect your results so you’re not conjuring up worst-case scenarios while you wait to hear back.
* Afterward, treat yourself to your favorite little indulgence – you’ve earned it. Go to a movie, get a pedicure, or have a piece of pie.