Many cancer patients have this question: Why do I insist on physical examination, but the cancer is still in the advanced stage when it is discovered? Here is the difference between cancer screening and ordinary physical examination.
To put it simply, our routine physical examination is like a big sieve. The "big stones" are screened out first, but the smaller stones may leak out. The physical examination cannot cover all the organs, and there is still a risk of tumors in the unchecked organs. There are two types of tumor growth: explosive and occult. Patients with early tumors in the occult stage of tumor growth are difficult to find by routine physical examination.
Cancer screening is essential
Cancer screening is a physical examination for common cancers based on cancer risk assessment. It allows the subject to know their own cancer risk and detect early cancer or precancerous lesions for early intervention. Before the physical examination, professional doctors will carefully ask the examinee’s physical condition, living habits, past medical history and family genetic history, etc., and then make the corresponding examination plan. The items mainly include: routine items, imaging diagnosis (ultrasound, mammography, low-dose CT) Etc.), tumor marker inspection, and endoscopy if necessary. The physical examination report should be interpreted by an experienced general examiner at or above the deputy senior level.
Before cancer screening, it is necessary for us to understand the common cancer types and high-risk groups, and to combine our own age, family history, gender, living habits and other factors to initially select screening items.
——High incidence of cancer in the whole population——
Lung cancer, liver cancer, colorectal cancer, and gastric cancer, these four types of cancers basically have no gender difference, and belong to the high incidence of cancer in the whole population. Of course, there are still differences among high-risk groups based on the location and principle of the disease.
Lung cancer
high-risk groups: age 50 to 75 years; each year of smoking is greater than or equal to 20 packages, including former smoker, but quit less than 15 years; long-term passive smokers (basic daily contact with more than 20 years); asbestos, beryllium, uranium, A history of occupational exposure to radon, etc.; a history of chronic obstructive pulmonary disease or chronic pulmonary fibrosis; a history of malignant tumors or a family history of lung cancer.
Screening method: low-dose spiral CT of the chest once a year. If lung nodules are found, follow the doctor's recommendation or visit a specialist for further examination and monitoring.
Liver cancer
high-risk groups: ages 40 to 69 years; with hepatitis B, hepatitis C, or carry the hepatitis B, hepatitis C virus were; cirrhosis; alcohol liver or other liver disease; there is a family history of liver cancer.
Screening method: do abdominal ultrasound once every six months; high-risk groups will receive a serum alpha-fetoprotein (AFP) examination once every six months. It is recommended to do hepatitis B virus surface antigen and hepatitis C antibody tests at the same time; if abnormalities are found, further enhanced CT examinations should be done .
Colorectal cancer
High-risk population: 45-74 years old; first-degree relatives have a history of colorectal cancer; I have a history of other malignancies; have had intestinal polyps; history of chronic appendicitis or appendectomy; history of chronic biliary disease or cholecystectomy; long-term (recent) 2 years persistent) Chronic constipation or chronic diarrhea, anorectal symptoms such as mucus and blood in the stool for 2 consecutive weeks.
Screening method: the general population will have an immunochemical fecal occult blood test (FIT) once a year; stool DNA testing will be done every 1 to 3 years; a fine magnifying colonoscopy will be done every 5 to 10 years; the first time for high-risk groups The inspection result determines the next inspection time.
Stomach cancer
high-risk groups: ages 45 and older; long live the high incidence of gastric cancer; the presence of Helicobacter pylori infection; past with chronic atrophic gastritis, gastric ulcer before, gastric polyps, gastric remnant after surgery, hypertrophic gastritis, pernicious anemia stomach cancer Diseases; bad lifestyle habits that may cause gastric cancer, such as smoking, alcohol addiction, high-salt or pickled diets, etc.; first-degree relatives (parents, children, or siblings of the same mother) suffering from gastric cancer.
Screening methods: Serum pepsinogen and gastrin-17 testing can help determine whether there is gastric mucosal atrophy and degree of atrophy. It can be used as an annual routine screening item; Helicobacter pylori examination can be used as an annual Routine screening items; when the above-mentioned examinations find abnormalities, it is recommended to do fine magnifying gastroscopy. High-risk groups with a family history of gastric cancer should do regular gastroscopy according to the doctor's recommendation. You can also do fine magnifying gastroscopy directly, which is the gold standard for early gastric cancer screening.
——High incidence of cancer in
women — Speaking of high incidence of cancer in women, many people first think of breast cancer. In fact, in addition to breast cancer, women also need to pay attention to the occurrence of cervical cancer, thyroid cancer and other cancers.
Breast cancer
high-risk groups: ages 45 and older; have first-degree relatives with breast cancer before the age of 50; history of contralateral breast cancer; breast cancer carrying the pathogenic genetic mutations.
Screening method: color Doppler ultrasound examination, once every 1-2 years after the age of 45; high-risk groups can get mammography examination once every 1-2 years.
Thyroid cancer
High-risk population: a history of head and neck radiation exposure or exposure to radiation dust in childhood; head and neck radiotherapy for other diseases; past or family history of differentiated thyroid cancer (DTC), medullary thyroid cancer, etc.; thyroid nodules It is larger than 1 cm, and the nodules grow rapidly, and grow to more than 1 cm within half a year; or the thyroid nodules are larger than 1 cm, accompanied by persistent hoarseness, dysphonia, dysphagia or dyspnea, and vocal cord lesions (inflammation, Polyps, etc.); Thyroid nodules are larger than 1 cm with swollen lymph nodes in the neck; Calcitonin is higher than the normal range.
Screening method: General population under 30 years old can have a clinical neck examination every 2 to 3 years; for high-risk groups or people over 30 years old, it is recommended to have neck ultrasound examination once a year; women before pregnancy and at the end of lactation , It is recommended to perform a neck ultrasound examination respectively.
Cervical cancer
high-risk population: married or sexually active 3 years of women; there had HPV infection, immune dysfunction, intrauterine diethylstilbestrol exposure history, but had or cervical intraepithelial neoplasia grade 2 and 3, in situ of the cervix Adenocarcinoma, women who have received treatment for invasive carcinoma of the cervix.
Screening method: cytology screening every 3 years for those aged 24 to 29 years; cytology screening every 3 years or HPV screening every 5 years for 30 to 64 years old ; If both cytology and HPV screening are negative, it can be changed to once every 5 years; for those over 65 years old, if 3 consecutive cytology screenings are negative or 2 consecutive HPV negatives in the past 10 years, there is no child A history of cervical intraepithelial neoplasia (CIN) does not require further screening. If cervical lesions have reached CIN 2-3 or have a history of adenocarcinoma in situ, screening should be continued for 20 years after the lesions have resolved naturally or after clinical treatment.
- male high incidence of cancer -
for men, the following three kinds of cancer in need of special attention -
esophageal cancer
high-risk groups: ages 40 to 69 years old; eating pickled, smoked food; eating too hot food, leftovers; Suffer from reflux esophagitis and other upper gastrointestinal diseases; have a family history of esophageal cancer; live in a high-risk area of esophageal cancer for a long time.
Screening method: high-risk groups need gastroscopy. The time of the next examination depends on the results of the first examination (follow the doctor's recommendation).
Prostate cancer
high-risk groups: over the age of 50 years; long-term suffering from chronic prostatitis; there is a family history of prostate cancer.
Screening methods: digital rectal examination, which can be performed once a year; ultrasound examination; high-risk groups can be tested for prostate antigen (PSA) once every two years.
Pancreatic cancer
high-risk groups: older than 40 years old; obstructive jaundice unexplained; the recent unexplained weight decreased by more than 10%; unexplained dyspeptic symptoms, abdominal or back pain appears, but normal endoscopy; sudden Diabetes without predisposing factors; sudden steatorrhea; spontaneous pancreatitis; long-term heavy smoking and drinking; family history of pancreatic cancer; benign gastric resection for more than 20 years.
Screening methods: tumor marker CA19-9 examination, endoscopic ultrasound, magnetic resonance imaging or magnetic resonance cholangiopancreatography, and if necessary, a needle biopsy is performed to confirm the diagnosis. If no lesions are found, an annual test will be carried out.
In short, cancer screening is highly professional, so we must choose a qualified institution, especially the qualifications of medical examiners and report interpretation doctors. Moreover, cancer screening is not "one-time-and-for-all". Different high-risk groups should be screened regularly under the advice of specialists. If signs of cancer are found, they should be diagnosed and treated in time.
Scientifically prevent cancer, start from life
To deal with tumors, prevention is greater than cure. In addition to the above-mentioned targeted regular screening, comprehensive research shows that starting with lifestyle and taking active preventive measures can help keep you away from cancer.
1. Eat red fruits and vegetables often. Red fruits and vegetables such as watermelon, tomatoes and red grapefruit are rich in lycopene. Many studies have proved that lycopene can help prevent cancer.
2. Embrace the sun. Vitamin D helps prevent breast cancer, bowel cancer, non-Hodgkin's lymphoma and many other cancers. The human body cannot synthesize vitamin D by itself and needs sufficient ultraviolet light to activate it. You can benefit from exposure to the sun for 10-15 minutes a day. It is best to dry your arms and back, not through the glass. It should be reminded that although sun exposure is good, excessive exposure is not recommended. When the ultraviolet rays are too strong, try not to get exposed to the sun as much as possible. It is recommended to take sunscreen when you go out, such as applying sunscreen, wearing sunscreen clothes, hats and sunglasses.
3. Maintain weight. The American Cancer Society pointed out that 20% of cancer deaths in women are related to overweight or obesity, compared with 14% in men. Losing excess weight can reduce the body's production of estrogen and prevent breast cancer, endometrial cancer and cervical cancer.
4. Exercise 30 minutes a day. Exercise for 30 minutes a day and at least 5 days a week is the best "anti-cancer artifact." Any exercise can optimize the level of sex hormones and help women stay away from estrogen-driven cancers, such as ovarian cancer, endometrial cancer and certain types of breast cancer. Canadian studies have found that persistent exercise can reduce the risk of ovarian cancer by 30%. Exercise can also accelerate intestinal peristalsis, promote waste discharge, and prevent colon cancer.
5. Quit smoking completely. Any part of tobacco smoke passing through before reaching the lungs, including the mouth, throat, esophagus, etc., may become cancerous. Within 15 years after quitting smoking, the risk of lung cancer will drop to the low level before smoking. Not only do you have to quit smoking, but you must also urge people around you to quit, because secondhand smoke can also cause lung cancer and increase the risk of cervical cancer by 40%.
6. Do more housework. White-collar women or housewives always complain that they are too busy to exercise. A Canadian study pointed out that most women's exercise is achieved through housework, which can reduce the risk of breast cancer in postmenopausal women by 30%.
>>Related Links Cancer Screening 4 Q&A
1. The more items to be screened, the better?
Some people think that since cancer screening is to be done, it must be thorough, and they even think that the more inspection items, the more accurate, but in fact, cancer screening also pays attention to "degree", not that the more items and the more expensive, the better . It is not recommended for everyone to do a full set of projects. One is to avoid economic waste, and the other is that chest radiographs, CT and other examinations are damaging, and doing too much will cause certain damage to the body.
In addition, some medical examination institutions use PET-CT (a novel imaging technology) as a high-end supplement for cancer screening. Experts suggest that PET-CT is not recommended for routine cancer screening unless there is a special need or other examination results have obvious cancer suspicion.
2. The tumor markers must be accurate?
Tumor markers are substances that are shed from the cell surface during the proliferation of tumor cells, or are produced by tumor cells, or produced by immune reactions with the human body. However, it also exists in benign tumors, embryonic tissues and even normal tissues. , Inflammation, etc. may make it rise.
Tumor markers are not sensitive enough and can only be used for physical examination rather than screening in my country. Experts emphasize that the missed detection rate of tumor markers is high, and not every cancer has a specific tumor marker.
3. Can cancer screening be done at any time?
Some people think that cancer screening is like seeing a doctor. They can be done at any time without preparation in advance. In fact, there are some restrictions on cancer screening in medicine. It is not that you can check when you want to. For example, cervical cancer screening cannot be during menstruation or pregnancy; spicy food should not be eaten before bowel cancer screening. Wait. If there is no advance preparation before the screening, it is easy to cause missed diagnosis and misdiagnosis.
4. Is it enough to check once?
Some people do not find any problems after undergoing a cancer screening. They think that there will be no problems in recent years or even in the future, so they will not do cancer screenings later. In fact, abnormal genetic mutations can induce cancer, and this also leads to the unpredictability of cancer. Therefore, we cannot detect cancer by only one cancer screening. Even if we do regular screening every year, it is possible to find cancer cells between two screenings. Therefore, a normal screening result does not guarantee a worry-free period of several years. At the same time, people with a high risk of cancer should appropriately increase the frequency of screening.
