Chapter 078. Prevention and Early Detection of Cancer (Part 8) Screening for Specific Cancers Widespread screening for cervical, colon, and likely breast cancer is beneficial for certain age groups. A number of organizations have considered whether or not to endorse routine use of certain screening tests. Because these groups have not used the same criteria to judge whether a screening test should be endorsed, they have arrived at different recommendations. The U.S. Preventive Services Task Force (USPSTF), the Canadian Task Force on Preventive Health Care, and the American Cancer Society (ACS) publish screening guidelines (Table 78-3). Special surveillance of those at high risk for a specific cancer because of a family history or a genetic risk factor may be prudent, but few studies have assessed the influence on mortality. Table 78-3 Screening Recommendations for Asymptomatic Normal- Risk Subjects a Test or Procedure USPSTF ACS CTFPHC Sigmoidoscopy Fair evidence to recommend ≥50, every 5 years Fair evidence to consider Fecal occult blood testing ≥50, good evidence for every 1–2 years ≥50, every year Good evidence, age ≥50 Colonoscopy No direct evidence ≥50, every 10 years No direct evidence Digital rectal examination No recommendation No recommendation No recommendation Prostate- Insufficient M: ≥50, Recommendation specific antigen evidence to recommend every year against Pap test F: 18– 65, every 1–3 years F: with uterine cervix, beginning 3 years after first intercourse or by age 21. Yearly for standard Pap; every 2 years with liquid test. Fair evidence to include in examination of sexually active women Pelvic examination No recommendation, advise adnexal palpation during exam for other reasons F: 18– 40, every 1– 3 years wi th Pap test; >40, every year Not considered Breast self- examination No recommendation ≥20, monthly Fair evidence to exclude Breast clinical examination Insufficient evidence as a stand-alone without mammography F: 20– 40, every 3 years; >40, yearly F: 50– 69, every 1–2 years Mammography F: 40– 75, every 1– 2 years (fair evidence) F: ≥40, every year F: 50– 69, every 1–2 years Complete skin examination Insufficient evidence for or against Periodic exam Poor evidence to include or exclude a Summary of the screening procedures recommended for the general population by U.S. Preventive Services Task Force (USPSTF), the American Cancer Society (ACS), and the Canadian Task Force on Prevention Health Care (CTFPHC). These recommendations refer to asymptomatic persons who have no risk factors, other than age or gender, for the targeted condition. Note: F, female; M, male. . Chapter 078. Prevention and Early Detection of Cancer (Part 8) Screening for Specific Cancers Widespread screening for cervical, colon, and likely breast cancer is beneficial. Preventive Health Care, and the American Cancer Society (ACS) publish screening guidelines (Table 78-3). Special surveillance of those at high risk for a specific cancer because of a family history. a Summary of the screening procedures recommended for the general population by U.S. Preventive Services Task Force (USPSTF), the American Cancer Society (ACS), and the Canadian Task Force on Prevention